胸水脱落细胞DNA含量及VEGF, p53与CEA表达在良恶性胸腔积液.docVIP

Clin ica l Exper ience·临床经验 胸水脱落细胞DNA含量及VEGF, p53和CEA表达在良恶性胸腔积液鉴别中的意义 周　箴1 ,陈　岗2 ,宣学金2 ,张　俭2 (1. 上海市肺部肿瘤临床医学中心,上海　200030; 2. 上海交通大学附属胸科医院病理科,上海　200030) [摘要] 　目的:探讨检测胸水细胞的DNA倍体以及VEGF、p53、CEA表达鉴别良恶性胸腔积液的价值。 方法: 73例胸腔积液患者,良性组13例,恶性组60例。图像细胞光度技术( image cytometry, ICM)进行DNA含量检测,免疫组化Envision法检测VEGF、p53、CEA。 结果:良性胸水DNA异倍体率仅占23. 1%。恶性胸水的异倍体率占77. 8% ,两者有统计学差异( P = 0.001) 。良性胸腔积液患者VEGF、p53、CEA表达率分别为12. 5%、0、0。恶性胸腔积液VEGF、p53、CEA表达率分别为17. 5% ,17. 5%和68. 4% ,与良恶性胸腔积液中CEA的表达相比有统计学差异( P 0. 001) ,VEGF和p53的表达无显著差异( P = 0.722, P = 0. 198) 。经DNA倍体联合VEGF、p53、CEA检测,敏感率可达90. 4% ,特异度87. 5% ,符合率90%。 结论: ICM检测胸水细胞的DNA倍体联合VEGF、p53、CEA表达值得进一步探讨,有可能成为鉴别良恶性胸腔积液的又一方法。 [关键词] 　肺肿瘤; 胸腔积液,恶性; DNA; 基因表达; 免疫组织化学; 诊断,鉴别 [中图分类号] 　R734. 2; R730. 43　　[文献标识码] 　A　　[文章编号] 　100027431 (2007) 0220155203 Clin ica l sign if icance of DNA content and VEGF, p53 and CEA expressions in the differentia l diagnosis of ma lig2 nant and ben ign pleura l effusions ZHOU Zhen1 , CHEN Gang2 , XUAN Xue2jin2 , ZHANG J ian2 　( 1. Shanghai Lung Tumor ClinicalMedical Center, Shanghai 200030, China; 2. Department of Pathology, Shanghai Chest Hosp ital of J iaotong University, Shanghai 200030, China) [ ABSTRACT] 　Objective: To investigate whether nuclear DNA content and vascular endothelial growth factor (VEGF) , p53 andcarcinoembryonic antigen (CEA) exp ressions had a potential value in differential diagnosis of malignant and benign p leural effusions. Methods: Seventy2three patientswith unilateral p leural effusion were divided into 2 group s: benign group ( n = 13) andmalignant group( n = 60). The DNA contentwasmeasured by the image cytometry ( ICM) and the level ofVEGF, p53 and CEA exp ressionswere de2tected by immunohistochemical Envision method. Results: The rates of aneup loid in benign and malignant p leural fluids were 23. 1%and 77. 8% , respectively. The difference between the benign andmalignant p leural effusionswas significant ( P 0. 001). Immunohis2tochemical staining showed that the positive rates of the VEGF, p53,