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目的 探讨胸腔积液中端粒酶活性 (TA)与端粒酶催化亚单位 (hTERT)在胸腔积液诊断中的价值。方法 将 5 1例胸腔积液患者按最终临床诊断结果分为恶性 (2 7例 )、良性 (2 4例 )两组 ;应用TRAP -ELISA法检测标本的端粒酶活性 ,结果以OD值表示 ,组间比较用t检验 ;计算该方法的敏感性、特异性、阳性预测值、阴性预测值、准确性等 ;应用免疫印迹法 (westernblotting)检测胸腔积液中的hTERT ,两种检测方法比较用 χ2 检验。结果 TA检测 :2 7例恶性胸腔积液中有 2 4例阳性 ;分离的肿瘤细胞全部阳性 ;2 4例良性胸腔积液中只有 1例TA检测阳性 (1/2 4) ;TA检测的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为 88 9%、95 8%、96%、88 5 %、92 2 %。hTERT检测 :在 2 7例恶性胸腔积液中有 8例hTERT检测阳性 ,12例良性胸腔积液中无 1例检测出hTERT。TA与hTERT两种检测方法比较有非常显著差异 (χ2 =19 64 ,P <0 0 1)。结论 TA检测可作为胸水常规诊断方法 ,hTERT检测可作为补充诊断方法用于临床。
Objective To investigate the value of telomerase activity (TA) and telomerase catalytic subunit (hTERT) in the diagnosis of pleural effusion. Methods 51 patients with pleural effusion were divided into two groups according to the final clinical diagnosis: malignant (27 cases) and benign (24 cases). The telomerase activity was detected by TRAP-ELISA. The results were expressed as OD , Between groups were compared with t test; calculate the sensitivity, specificity, positive predictive value, negative predictive value, accuracy of the method; Western blotting detection of hTERT in pleural effusion, the two detection methods Χ2 test. Results TA test showed that 24 of 27 malignant pleural effusions were positive, all the tumor cells isolated were positive, only 1 of 24 benign pleural effusion had positive TA (1/2 4). The sensitivity of TA The positive predictive value, the negative predictive value, and the accuracy were 88 9%, 95 8%, 96%, 88 5%, 92 2% respectively. hTERT assay: hTERT was positive in 8 out of 27 malignant pleural effusions and hTERT in none of 12 benign pleural effusions. There was a significant difference between TA and hTERT (χ2 = 19 64, P <0.01). Conclusion TA detection can be used as a routine diagnostic method of pleural fluid, hTERT detection can be used as a supplementary diagnostic method for clinical use.