The Value Of Liquid-based Cytologic Test In Diagnosis Of Benign And Malignant Pleural Effusion

Objective: To investigate the application and significance of liquid-based cytology test and liquid-based cytology test combined with traditional smears and DNA ploidy analysis in the diagnosis of benign and malignant pleural effusions.Methods: The 160 pleural effusion samples were collected from the Respiratory Department of Affiliated Hospital of Zunyi Medical University during May 2016 to January 2018.74 cases of benign pleural effusion were diagnosed by clinical diagnosis and Histopathology,and 86 cases were diagnosed as malignant pleural effusion by pathology.both pleural effusion samples examined by LBC,CS and DNA ploidy analysis.Result:1.Comparison of Sensitivity in single detection methods: The LBC sensitivity was 79.07%,the specificity was 98.65%,the accuracy was 88.13%;the CS sensitivity was58.14%,the specificity was 91.89%,the accuracy was 73.75%;the DNA ploidy analysis sensitivity was 81.40%,the specificity was 89.19 %,the accuracy is 85.00%.Compared with CS,the sensitivity and accuracy of LBC were increased,and the difference was statistically significant(P<0.05).Compared with CS,the specificity of LBC had no significant change,and there was no significant difference(P>0.05).Compared with the DNA ploidy analysis,the specificity of LBC increased,and the difference was statistically significant(P<0.05).Compared with the DNA ploidy analysis,the sensitivity and accuracy of LBC had no significant changes,and there was no significant difference(P>0.05).Compared with CS,the sensitivity and accuracy of DNA ploidy analysis were increased,and the difference was statistically significant(P<0.05).Compared with CS,the specificity of DNA ploidy analysis was no significantly changed,and there was no statistical difference(P>0.05).The positive predictive value of LBC was 98.55%,negative predictive value was 80.22%,Youden index was 0.777,Kappa value was 0.765;CS positive predictive value was 89.29%,negative predictive value was 65.38%,Youden index was 0.500,Kappa value 0.487;The positive predictive value for DNA ploidy analysis was89.74%,the negative predictive value was 80.49%,the Youden index was 0.706,and the Kappa value was 0.701.The Youden index of LBC is higher than that of CS and DNA ploidy analysis,indicating that LBC has small random error and its diagnostic value is relatively high.The Kappa value of LBC was higher than that of CS and DNA ploidy analysis,indicating that the diagnosis of LBC on benign and malignant pleural effusions was highly consistent with pathological biopsy,and its clinical application value was better.2.The comparison of sensitivity with each combination detection:LBC+CS+DNA ploidy analysis(98.37%)>LBC+DNA ploidy analysis(96.11%)>CS+DNA ploidy analysis(92.21%)>LBC+CS(91.24%);Specificity comparison: LBC + CS(90.65%)>LBC+DNA(87.99%)>CS+DNA ploidy analysis(81.96%)>LBC+CS+ DNA ploidy analysis(80.85%);The accuracy of LBC+DNA ploidy analysis was 90.00%,Youden index was 0.841,and Kappa value was 0.798,which was higher than other combined tests.Conclusion: LBC has good accuracy and reliability in the determination of the nature of pleural effusion.It can be used as a reliable method for early screening of benign and malignant pleural effusions and is worthy of clinical application;Combined detection can significantly increase the positive detection rate of a single test,in which the LBC+DNA diagnosis of benign and malignant pleural effusions has the best overall effect.