DNA含量分析和非白细胞细胞群CD44分子的检测在胸腔积液诊断和鉴别诊断中的价值

Diagnostic value of DNA content and CD44 in non-leukocyte cells in pleural effusion

关键词:  胸腔积液  DNA含量  CD44  流式细胞术

Key words:  pleural effusions  DNA content  CD44  flow cytometry

摘要:

［目的］ 探讨胸水脱落细胞的DNA含量分析和非白细胞细胞群CD44分子的检测在诊断和鉴别诊断良、恶性胸腔积液中的作用。［方法］ 选取各种胸腔积液标本121例，包括恶性胸腔积液标本65例, 结核性胸腔积液24例, 和其他良性胸腔积液32例（对照组）。应用流式细胞术分别测定各组标本内DNA异倍体的含量、处于G₀/G₁ 期细胞的百分比及胸水脱落细胞中非白细胞细胞群的CD44分子的表达，并对结果进行分析。［结果］ 恶性胸腔积液组中，异倍体检出率为76.9%（50/65），DI值为1.14±0.03，而结核性胸腔积液组和对照组均未检出异倍体。G₀/G₁ 含量分析中，对照组G₀/G₁ 含量为（95.77 ± 2.30）%，PI （4.23±2.29)%；结核性胸腔积液组G₀/G₁ 含量高于对照组（P<0.05），为（98.53±0.77）%，PI为（1.2±0.81）%；而未检出异倍体恶性胸腔积液组（n=15），与对照组比较差异则无显著性意义（P>0.05），其G0/G1 含量为（95.20±2.10）%，PI为（4.75±2.50）%。胸水脱落细胞中，中性粒细胞、淋巴细胞等白细胞群的CD44分子表达率均为100%。非白细胞细胞群中，对照组中CD44分子表达率为（25.02±12.20）%，恶性胸腔积液组表达率为（52.15±25.15）%，明显高于对照组（P<0.01），而结核胸腔积液组为（21.98±13.02）%，与对照组相比差异无显著性意义（P>0.05）。［结论］ 对胸腔积液脱落细胞进行DNA分析及检测非白细胞群CD44分子有助于诊断和鉴别诊断良、恶性及结核性胸腔积液。

Abstract:

［Objective］ This work is to evaluate the role of DNA content and CD44 in non-leukocyte cells in diagnosis of pleural effusions. ［Methods］ One hundred and twenty-one patients with pleural effusion were divided into malignant pleural effusion group (n=65), tubercular pleural effusion group (n=24) and control group (n=32). DNA diploid, the percentage of G₀/G₁ in cell cycle and the expression of CD44 were examined by flow cytometry. ［Results］ (1) In malignant pleural effusion group, aneuploidy was detected in 50 of 65 patients (76.9%) and DNA index (DI) were 1.14±0.03, while the aneuploidy could not be seen in both tubercular pleural effusion and control groups. (2) In the analysis of the DNA cycle, the value of G₀/G₁ phase in tubercular pleural effusion group ［(98.53±0.77)%, PI (1.2±0.81) %］ was significantly higher than that in control group ［(95.77±2.30)%, PI (4.23±2.29) %］, P<0.05. In addition, there was no difference between malignant pleural effusion group with no aneuploidy ［n=15, (95.20±2.10)%, PI (4.75±2.50)%］and control group. (3) Among the cells of pleural effusion, leukocytes showed 100% CD44 positive. For non-leukocyte cells, compared with control group ［(25.02±12.20)%］, the positive percentage of CD44 in malignant pleural effusion group significantly increased ［(52.15±25.15)%］, P<0.01, while there was no difference between tubercular pleural effusion ［(21.98±13.02)%］and control groups(P>0.05).［Conclusion］ Detection of DNA content and CD44 in non-leukocyte cells would be helpful for diagnosis or differential diagnosis of benignant, malignant, or tubercular pleural effusions.