胸水淋巴细胞微核率检测在良、恶性胸腔积液鉴别诊断中的意义 _医学论文.docVIP

胸水淋巴细胞微核率检测在良、恶性胸腔积液鉴别诊断中的意义 _医学论文 胸水淋巴细胞微核率检测在良、恶性胸腔积液鉴别诊断中的意义 _医学论文 【关键词】 胸腔积液 关键词: 微核胸腔积液染色体，人染色体畸变 摘 要:目的 探讨胸水中淋巴细胞微核率（PFLMNF）对良、恶性胸腔积液鉴别诊断的意义. 方法 对良、恶性胸腔积液患者及健康人各20例采用细胞分裂阻滞微核（CB-MN）法检测外周血淋巴细胞微核率（PBLMNF）及用丝裂霉素C（MMC）诱发PBLMNF，直接用光镜观察PFLMNF. 结果 PFLMNF与PBLMNF有良好的相关性（r=0.935，0.01）.恶性胸腔积液患者自发PBLMNF及诱发PBLMNF均显著高于对照组和良性胸腔积液组（0.01）.良性胸腔积液组PBLMNF与对照组无统计差异（Pgt0.05）.恶性胸腔积液组PFLMNF较良性胸腔积液组明显升高（0.01）. 结论 PFLMNF检测方法简单、快速、实用，并可以代替PBLMNF检测，PFLMNF检测可成为良、恶性胸腔积液鉴别诊断的一种有实用价值的方法. 　　Keywords:micronucleipleural effusionchromosomes，hu-manchromosome aberrations 　　Abstract:AIM To investigate the significance of pleural fluid lymphocyte micronuclei frequency（PFLMNF）for diag-nosis of malignant pleural effusion and benign pleural effu┐sion.METHODS The modified cytokinesis-blocked mi-cronucleus（CB-MN）technique was used to determine pe-ripheral blood lymphocyte micronuclei frequency（PBLMNF）and mitomycin C（MMC）-induced PBLMNF in20cases with　benign pleural effusion，20cases with malignant pleural effu-sion and20health controls，while PFLMNF was investigated in the40patients at the same time.RESULTS There was a better correlation between PFLMNF and PBLMNF（r=0.935，0.01）.Spontaneous PBLMNF and MMC-induced PBLMNF of the malignant effusion group were much higher than that of the benign effusion group or the control group（0.01）.However，PBLMNFs in the latter two groups had no statistic difference（Pgt0.05）.PFMNF in the malig-nant effusion group were significantly higher than that in the benign group（0.01）.CONCLUSION PFLMNF test，which is a simple，fast，practical method，can be used to re-place the PBLMNF test.It is a practical diagnostic method for malignant pleural effusion and benign pleural effusion. 　　0 引言 　　胸腔积液常规方法多能定性诊断，但仍有部分难区分良、恶性.胸膜活检虽可信，但有创伤、阳性率低.为此人们尝试胸水细胞染色体畸变率、p53突变作为辅助诊断指标［1-5］ ，但需专门培训.微核检测简便、快速，是染色体损伤和染色体畸变的可靠替代指标.近些年研究发现多种肿瘤患者外周血淋巴细胞微核率（PBLMNF）及脱落细胞微核率增高［6-9］ ，肿瘤患者诱发微核率增加显著高于正常人，表明肿瘤患者染色体稳定性差 ［10，11］ .提示PBLMNF是潜在的肿瘤诊断的辅助指标.我们采用改良的Fenech［12］ 创建的胞质分裂阻滞法检测胸水患者自发及丝裂霉素诱发PBLMNF，直接