骨桥蛋白在良恶性胸腔积液中的表达及其临床价值  

Value of osteopontin in differential diagnosis of pleural effusions

作　　者：沈凌[1] 王利民[1] 祁明浩[1] 任振义[1] 

机构地区：[1]杭州市第一人民医院呼吸科,310006

出　　处：《国际呼吸杂志》2012年第21期1633-1636,共4页International Journal of Respiration

摘　　要：目的通过检测胸腔积液中骨桥蛋白（OPN）和癌胚抗原（CEA）、CA199的水平，探讨联合检测三项指标对于胸腔积液鉴别诊断的临床应用价值。方法收集2009年10月至2011年1月在杭州市第一人民医院呼吸科住院的胸腔积液患者85例，其中恶性胸腔积液39例，良性胸腔积液46例（其中结核性胸腔积液，肺炎旁胸腔积液30例）。取第一次胸腔穿刺术所得的胸腔积液标本，应用酶联免疫吸附试验法测定胸腔积液中OPN浓度。结果恶性胸腔积液中OPN浓度显著高于良性胸腔积液，与良性胸腔积液中各亚组比较差异均有统计学意义（P〈O．01）。根据ROC曲线，取OPN浓度2000ng／L为临界值，诊断恶性胸腔积液的敏感性为71．8％，特异性为95．7％，准确性为84．8％。联合检测OPN和CEA诊断恶性胸腔积液的敏感性为97．43％，特异性为95．65％，准确性为96．47％。结论测定胸腔积液中OPN浓度对鉴别良性、恶性胸腔积液有一定价值，与CEA联合诊断恶性胸腔积液时敏感性和特异性进一步提高，值得在临床推广。Objective To investigate the value of osteopontin（OPN） in the differential diagnosis of pleural effusion. Methods A total of 85 patients with pleural effusion during October 2009 to January 2011 were recruited at the department of respiratory medicine of Hangzhou First Hospital. Pleural effusion was malignant in 39 cases and benign in 46 cases. The patients were divided into a malignant pleural effusion group, an infective pleural effusion group, and a transudation group. Then the infective was further divided into subgroup of tuberculosis pleural effusion group and parapneumonic effusion group. Results The concentration of OPN was significantly higher in the malignant pleural effusion group compared with the benign pleural effusion groups （ P 〈0.01）. When the cutoff value of OPN was set at 2 000 ng/L, the sensitivity specificity and accuracy for the diagnosis of malignant pleural effusion was 71.8% ,95.7% and 84.8%, respectively. Furthermore, the detection of OPN in combination with CEA showed better diagnostic sensitivity （97.43%）, specificity （95.65%）, and accuracy （96.47%）. Conclusions The detection of OPN in pleural effusion is of some clinical significance in the differential diagnosis of malignant and benign pleura1 effusion.

关 键 词：骨桥蛋白 胸腔积液 肿瘤标志物 肺癌 

分 类 号：R561[医药卫生—呼吸系统]