Cytogenetic diagnosis of malignant pleural effusions: culture methods to supplement direct preparations in diagnosis.
Cytogenetic diagnosis of malignant pleural effusions: culture methods to supplement direct preparations in diagnosis.
复制标题
恶性胸腔积液的细胞遗传学诊断：培养方法补充诊断中的直接制剂。
作者：
G. Dewald;Hicks Ga;D. E. Dines;H. Gordon
通过直接制片、24小时和48小时培养以及长期培养，对100名未经选择的患者的胸腔积液进行了细胞遗传学研究。研究包括17例良性胸腔积液，76例恶性胸腔积液，7例原因不明。检测恶性病变的两个细胞遗传学标准：(1)三个或三个以上超二倍体或有标记的中期；(2)两个或两个以上具有相同标记的中期(克隆)。在恶性胸腔积液中，当使用第一种标准时，51例(67%)至少一种方法阳性，当使用第二种标准时，34例(45%)至少一种方法阳性。根据第一个标准，直接制片为阴性的13例(17%)至少有一种培养方法阳性；按第二个标准，有7例(9%)这样的病例。显然，单独的培养方法并不比直接制剂更好，但在补充直接制剂方面是有用的。根据第一个标准，有一个假阳性的长期培养。因此，恶性肿瘤的克隆标准可能更准确，但敏感性较低。没有证据表明治疗对细胞遗传学研究有任何影响。
Pleural effusions from 100 unselected patients were studied cytogenetically by direct preparation, 24- and 48-hour cultures, and long-term cultures. The study included benign pleural effusion in 17 patients, malignant pleural effusion in 76, and an indeterminate cause in 7. Two cytogenetic criteria for detecting a malignant lesion were tested: (1) three or more metaphases that were either hyperdiploid or had markers and (2) two or more metaphases with the same markers (clone). Among the malignant pleural effusions, 51 (67%) were positive by at least one method when the first criterion was used and 34 (45%) were positive by at least one method when the second criterion was used. By the first criterion, at least one of the culture methods was positive in 13 cases (17%) in which direct preparations were negative; there was 7 such cases (9%) by the second criterion. Apparently, culture methods alone are not better than direct preparations but are useful in supplementing direct preparations. There was one false-positive long-term culture by the first criterion. Thus, the clone criterion of malignancy may be more accurate but is less sensitive. There was no evidence that therapy had any effect on the cytogenetic studies.