腺苷脱氨酶、C-反应蛋白与癌胚抗原检测对胸腔积液的诊断价值

    Diagnosis value of aden6sine deaminase, C-reactive protein and carcinoembryonic antigen detection for pleural effusion

    • 摘要: 目的: 探讨胸腔积液中腺苷脱氨酶(adenosine deaminase,ADA)、C-反应蛋白(C-reactive protein,CRP)、癌胚抗原(carcinoembryonic antigen,CEA)的检测在胸腔积液鉴别诊断中的意义。方法: 以氨试剂法、散射比浊法和微粒子化学发光法分别检测39例结核性胸腔积液、18例恶性胸腔积液的ADA、CRP和CEA。结果: 以胸腔积液ADA≥40 IU/L、CRP≥10 mg/L和CEA<15 μg/L等单项指标为判断标准诊断结核性胸腔积液,其敏感性为95.2%,特异性为97.6%;以ADA<40 IU/L、CRP<10 mg/L和CEA≥15 μg/L等单项指标为判断标准诊断恶性胸腔积液,其敏感性为94.9%,特异性为96.7%。结论: 联合检测ADA、CRP和CEA为提高胸腔积液的鉴别诊断提供了可靠的实验依据。

       

      Abstract: Objective: This study was designed to characterize the ultrastructure of the coccoid Helicobacter pylori(H. pylori) forms in the tissues of carcinoma.Methods: Transmission electron microscopy(TEM) technique was used to examine the structure of coccoid H. pylori in 4 cases of gastric carcinoma and 2 cases of esophageal carcinoma.Results: It was found that the coccoid H. pylori were scattered in cancer nest and cancer interspace,some of which enterded cancer cells,macrophages and other cells.The coccoid H. pylori appeared to be similar to the L-forms of other bacteria with varying cell shape and size,different cytoplasmic electron densities and defects in cell wall.Two types of coccoid H. pylori could be distinguished in the tissues of carcinoma by TEM.Type A was smaller with higher electron density in the cytoplasma,and flagellation on the cell membrane,suggesting that it could be viable.However,the type B was larger with lower electron density in the cytoplasma,and no flagellation on the cell membrane,suggesting that it could be a degenerative form.Conclusions: The coccoid forms of H.pulori still have certain degree of viability,thus they may play an important role in the transmission of H. pylori,the relapse of H. pylori related disease after treatment and the development of the related carcinoma.

       

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