细胞因子IFN-γ,IL-2,TNF-α和ADA对结核性和恶性胸腔积液鉴别诊断的价值(英文)  

The Differential Diagnostic Value of Interferon-γ, Interleukin-2, Tumor Necrosis Factor α and Adenosine Deaminase in Tuberculous and Malignant Pleural Effusion

作　　者：任兆强 邢维聪 孙勇[1] 刘菲[1] 林存智[1] 

机构地区：[1]青岛大学附属医院,山东青岛266003

出　　处：《现代生物医学进展》2014年第23期4471-4474,共4页Progress in Modern Biomedicine

基　　金：Project supported by the Shandong Province medicine science and technology development plan(2009-194)~~

摘　　要：目的:探讨细胞因子γ-干扰素(IFN-γ)、白介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)和腺苷脱氨酶(ADA)对结核性和恶性胸腔积液的鉴别诊断的价值。方法:以2012年9月至2013年3月期间在青岛大学医学院附属医院呼吸科及青岛胸科医院未经治疗的胸腔积液患者为研究对象,其中恶性胸腔积液患者46例,结核性胸腔积液患者42例。采用双抗体夹心酶联免疫吸附测定法(ELISA)分别检测结核性和恶性胸腔积液患者中IFN-γ、IL-2、TNF-α及ADA的表达情况。并应用ROC曲线分析两组患者胸腔积液中IFN-γ、IL-2、TNF-α及ADA的表达差异及意义。结果:结核性胸腔积液组IFN-γ、IL-2、TNF-α及ADA的表达明显高于恶性胸腔积液组,差异有统计学意义(t=8.118、8.126、8.066、7.221;P=0.000、0.000、0.000、0.000,P<0.001);ROC曲线分析结果显示胸腔积液中IFN-γ、IL-2、TNF-α及ADA的诊断临界值为201.45 pg/mL、41.91 pg/mL、21.55 pg/mL、33.78 U/L;诊断敏感度分别为91.3%、93.5%、91.2%、89.1%;特异度分别为91.0%、92.1%、89.9%、90.1%。结论:胸腔积液中IFN-γ、IL-2、TNF-α及ADA的表达对结核性和恶性胸腔积液诊断与鉴别诊断具有重要参考价值。Objective： To explore the differential diagnostic value of interferon-γ（IFN-γ）, interleukin-2（IL-2）, tumor necrosis factor α（TNF-α）, and adenosine deaminase（ADA） level in the tuberculous and malignant pleural effusions. Methods： A total of eighty-eight specimens of pleural effusion were collected from 88 patients with pleural effusion in respiratorydepartment of affiliated Hospital of Medical College of Qingdao University and Qingdao Thoracic Hospital from September 2012 to March 2013. Among them,46 pleural specimens were diagnosed as malignant, and the others were diagnosed as tuberculous. Enzyme-linked immunosorbent assay（ESISA） was used to detect the concentration of IFN-γ, IL-2, TNF-α and ADA in tuberculous and malignant pleural effusions. Receive operating characteristic curve（ROC） analysis was used to analyze whether there are significant differences between the two groups of patients with pleural effusion in concentration of IFN-γ, IL-2, TNF-α and ADA. Results： Tuberculous pleural effusion group of IFN-γ,IL-2, TNF-α and ADA was significantly higher than that of malignant pleural effusion group, and the difference was statistically significant（ t = 8.118, 8.126, 8.066, 7.221; P〈0.05）; ROC analysis showed that pleural effusion of IFN-γ, IL-2, TNF-α and ADA in the diagnosis of the critical value of 201.45 pg/mL, 41.91 pg/mL, 21.55 pg/mL, 33.78 U/L, the sensitivity and specificity for IFN-γ, IL-2,TNF-α and ADA in pleural fluid were 91.3 %, 93.5 %, 91.2 %, 89.1 % and 91.0 %, 92.1 %, 89.9 %, 90.1 %, respectively.Conclusion：The IFN-γ, IL-2, TNF-α and ADA concentration in tuberculous and malignant pleural fluid are significant for the early diagnosis and differential diagnosis.

关 键 词：结核性胸腔积液 恶性胸腔积液 细胞因子 

分 类 号：R52[医药卫生—内科学]