【摘要】 目的 :探讨端粒酶活性测定对恶性与良性胸腔积液的诊断与鉴别诊断价值。方法 :采用聚合酶链反应 -酶联免疫吸附分析法 (PCR ELISA)检测 4 3例恶性胸腔积液和 2 4例良性胸腔积液的端粒酶活性 ,并与胸腔积液细胞学及癌胚抗原 (CEA)测定结果进行比较。结果 :恶性胸腔积液组端粒酶阳性率为 74 .4 2 % ,良性胸腔积液组阳性率为 1 2 .5 0 % ,差异有显著性 (P <0 .0 0 5 ) ;端粒酶活性检测对恶性胸腔积液诊断敏感性为 74 .4 2 % ,特异性为 87.5 %。恶性胸腔积液组胸腔积液细胞学检查与CEA测定阳性率分别为 5 1 .1 6 %和 4 6 .5 1 % ,均低于端粒酶活性检测 (P <0 .0 1 )。结论 :胸腔积液端粒酶活性检测对恶性胸腔积液诊断有重要价值 ,与细胞学检查、CEA测定联合应用可提高恶性胸腔积液的诊断率更多还原

【Abstract】 Objective:To determine the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a nonmalignant pleural effusion.Methods:Using a PCR(polymerase chain reaction) based TRAP(telomeric repeat amplification protocol) assay combined with ELISA(enzyme linked immunosorbent assay),we examined telomerase activity in the pleural fluid cells obtained from 43 patients with malignant neoplasms and 24 patients with benign lesions.The result was compared with that by cytological diagnosis and determination of carcinoembryonic antigen(CEA).Results:The presence of telomerase activity was observed in 32 of 43 samples of malignant pleural effusions,and in 3 of 24 samples of nonmaligant pleural effusions.The difference was significant( P <0.005).The detection of telomerase activity had a sensitivity of 74.42% to the diagnosis of malignant pleural effusions and a specificity of 87.5%,respectively.The overall positive rate in 43 malignant pleural effusion cell samples by cytological examination and by the determination of CEA was 51.16% and 46.51%,respectively.The positive rate detected by cytological examination and CEA was significantly lower than that by telomerase activity( P <0.01).Conclusions:Our results indicate that the detection of telomerase activity is of great value in the diagnosis of malignant pleural effusions.The diagnosis will be more reliable of combined with cytological examination and CEA determination.更多还原