Differential diagnosis of benign and malignant lung diseases by DNA ploidy combined with cytokeratin-19 fragment detection in pleural fluid
Objective To investigate the significance of detecting DNA ploidy combined with cytokeratin-19 fragment(CYFRA-21-1)in pleural fluid on differential diagnosis of benign and malignant lung diseases.Methods A retrospective analysis was performed on 78 patients diagnosed with non-small cell lung carcinoma and pleural effusion admitted to Zhejiang Rongjun Hospital from May 1,2021 to December 1,2023 as the case group,and 50 patients with benign lung disease and pleural effusion who were admitted to the hospital during the same period as the control group.DNA ploidy and CYFRA-21-1 in pleural fluid and peripheral blood samples of all patients were detected,and the efficacy of DNA ploidy and CYFRA-21-1 in peripheral blood and pleural fluid samples was statistically compared.Results The positive rates of DNA ploidy and CYFRA-21-1 in pleural effusion and peripheral blood in the case group were all significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).In the case group,the positive rates of DNA ploidy and CYFRA-21-1 in pleural fluid were significantly higher than those in peripheral blood(both P＜0.05);The AUC of pleural fluid DNA ploidy combined with CYFRA-21-1 in the identification of benign and malignant lung diseases was 0.980,which was greater than that of the single index of pleural fluid DNA ploidy(0.964)and that of pleural fluid CYFRA-21-1(0.900;both P＜0.05);the sensitivity,specificity,and accuracy of the detection of benign and malignant lung diseases by pleural fluid DNA ploidy combined with CYFRA-21-1 were 1.00,0.96,and 0.98,respectively.Conclusion The abnormal DNA proliferation and increased positive rate of CYFRA-21-1 are found in pleural fluid of lung carcinoma patients,which are much earlier than those of peripheral blood specimens.The combined detection of pleural fluid DNA ploidy and CYFRA-21-1 can help improve the differential diagnosis between benign and malignant lung diseases,which deserves attention.
Lung carcinomaDNA ploidyPleural effusionFlow cytometryCytokeratin-19 fragment
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