Clinical Significance Of Detection Of DNA Ploidy Joint MiR-21 And MiR-24 In Discriminating Benign And Malignant Pleural Effusion

Objective:To study cell DNA ploidy and mi R-21, mi R-24 expression levels in benign and malignant pleural effusion, and their diagnostic value of malignant pleural effusion.Methods: We collected the pleural effusion of 40 patients with benign and malignant pleural effusion in the second People’s hospital of Yueyang from May 2015 to September 2015.Hematoxylin-eosin staining for conventional cytology examination by microscope,fleugen staining for DNA ploidy examination by automatic image analysis system,and compared their detection rate and diagnostic value of malignant pleural effusion.We measured the expression of mi R-21 and mi R-24 using real-time PCR.Mann-whitney U test was used to compare the expression difference of mi R-21 and mi R-24 between malignant and benign pleural effusion.And ROC was used to evaluate the diagnostic value of malignant pleural effusion by the expression level of mi R-21、mi R-24 and DNA ploidy.Results:1.The positive detection rates of malignant cells in pleural effusion by conventional cytology was 32.5%,by DNA ploidy analysis was 42.5%.The difference was significant among the(P<0.05).ICM-DNA positive rate of detection of malignant cells higher than that of conventional cytology.2.The sensitivity of conventional cytology diagnosis of malignant pleural effusion was 65%, specificity was 90%.The AUC for conventional cytology was 0.775, 95% CI 0.624 to 0.926.DNA ploidy analysis sensitivity of diagnosis of malignant pleural effusion was 85%, specificity of 80%.The AUC for DNA ploidy analysis was 0.825, 95% CI 0.687 to 0.963.The AUC for both joint diagnosis of malignant pleural effusion was 0.893, 95% CI 0.781 to 1.004.3.The relative expression level of mi R-21 was 16.322±13.031 in BPE and 69.143±41.233 in MPE.The expression level of mi R-21 was significantly higer in MPE than in BPE(P<0.05).The relative expression level of mi R-24 was 15.040±9.515 in BPE and 73.358±80.771 in MPE.The expression level of mi R-24 was significantly higer in MPE than BPE(P<0.05).4.The AUC for expression level of mi R-21 in pleural effusion was 0.913, 95% CI 0.828 to 0.997.The AUC for expression level of mi R-24 in pleural effusion was 0.915,95% CI 0.832 to 0.998.The AUC for both joint diagnosis of malignant pleural effusion was 0.978, 95% CI 0.942 to 1.013.5.The AUC for DNA ploidy analysis combined with mi R-21 diagnosis of malignant pleural effusion was 0.943, 95% CI 0.873 to 1.104.The AUC for DNA ploidy analysis combined with mi R-24 diagnosis of malignant pleural effusion was 0.948, 95% CI 0.886 to 1.009.Conclusion:1.The conventional cytology joint DNA ploidy detection can improve the diagnostic value of malignant pleural effusion.2.DNA ploidy detection can be compensate for the short of cell pathomorphology.3.Use q RT-PCR method successfully detected mi R-21, mi R-24 expression in pleural effusion cells sediment,and the expression level of both were significantly higer in MPE than in BPE.Both can be used as a potential molecular markers to discriminate benign and malignant pleural effusion.4.DNA ploidy analysis joint mi R-21, mi R-24 can improve the sensitivity of discriminating benign and malignant pleural effusion.