摘要:目的探讨DNA倍体分析系统鉴别良恶性胸腔积液的价值。方法40例胸腔积液患者分为恶性胸
液组及良比胸腔积液组，抽取胸腔积液，细胞离心后涂片，瑞氏染色行常规细胞学检查，用Feulgen染色做全自
动DNA图像分析。结果恶性胸液组，常规细胞学检查7例为肿瘤细胞，4例核异型细胞，细胞学检查阳性率
28.0% ;DNA倍体分析系统检测21例为阳性，阳性率为94.0%;良性胸液组常规细胞学均为大量炎性细胞和少
许间皮细胞，DNA倍体分析系统分析巧例均未见DNA倍体异常细胞。结论DNA倍体分析系统可为良恶
性胸腔积液诊断提供依据，是病理学检查的有益补充。
    关键词:胸腔积液;DNA倍体分析;细胞学
    中图分类号:8446.74文献标识码:A
Differential diagnostic values of DNA-image cytometry in
        benign and malignant pleural effusions
GUO Guang-yun', ZHANG Li-bo', CHEN Gong', KUANG Jun', YANG Li', ZHANG Lie
(I.Department of Respiratory Medicine, 2.Department of pathology, People's Hospital
      Affiliated to Yunyang Medical College, Shiyan, Hubei 442000, P.R.China)
  Abstract: [Objective] To appraise the differential diagnostic values of DNA-image cytometry in benign and
malignant pleural effusions. [Methods] 40 samples of pleural effusions, cells of pleural effusions were spun on 4
slides by a cytospin in each sample. The smears collected were submitted to the image analysis following a-three
step protocol (smears stained with Wright's staining method were destained and then restained with Feulgen staining
and finally analyzed using image analysiscytometry). [Results] Among malignant group, tumour cells were found in
7 cases, 4 cases were diagnosed as nuclear atypia cell in conventional cytological examination, the positive rate was
28.0%. And in contrast 21 cases were found positive in DNA image cytometry, the positive rate was 84.0%. In be-
nign pleural effusions, a great many inflamation cells and few mesothelial cells were found, there was no DNA ploid
abnormal cell. [Conclusions] DNA image cytometry for pleural effusions is helpful in raising the positive rate of cy-
topathological diagnosis in malignant pleural effusions, and provides evidences for differemon of malignant pleural
effusions from benige effusions.
  Key words: pleural effusion; DNA-image; cytometry
    胸腔积液是呼吸科常见的疾病之一，其形成原
因较复杂，可分良性与恶性胸腔积液。胸腔积液中
直接找到肿瘤细胞仍是目前确诊恶性胸腔积液的最
迅速、可靠、经济的方法之一，但常规细胞学检查敏
感度只有40%左右[[1]。寻找诊断癌性胸液诊断及鉴
别诊断较敏感和特异性指标是我们临床工作者迫切
需要解决的问题r21。近年来，许多学者通过检测体腔
积液里的DNA倍体来鉴别间皮瘤、良哇反应性间皮
细胞和腺癌，并应用DNA图像分析技术和流式细胞
仪技术诊断恶性浆膜腔积液[[3.4]。本研究采用全自动
DNA图像分析仪对胸腔积液的细胞行DNA含量测
定，以探讨该技术对良恶性胸腔积液的鉴别诊断价
值。

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