胰岛素样生长因子结合蛋白2和癌胚抗原对恶性胸腔积液与结核性胸腔积液的鉴别诊断价值分析  

Differential Diagnostic Value of IGFBP-2 and CEA between Malignant and Tuberculous Pleural Effusion

作　　者：周晓明[1] 康大海[2] 侯刚[2] 尹燕[2] 赵立[1] 

机构地区：[1]中国医科大学附属盛京医院呼吸科,辽宁省沈阳市110004 [2]中国医科大学附属第一医院呼吸疾病研究所,辽宁省沈阳市110001

出　　处：《实用心脑肺血管病杂志》2017年第1期95-98,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：辽宁省教育厅科学研究一般项目(L3013310);沈阳市科学技术项目计划(F13-316-1-72)

摘　　要：目的分析胰岛素样生长因子结合蛋白2(IGFBP-2)和癌胚抗原(CEA)对恶性胸腔积液(MPE)与结核性胸腔积液(TPE)的鉴别诊断价值。方法选取2012年6月—2013年12月中国医科大学附属第一医院、中国医科大学附属盛京医院及沈阳市胸科医院收治的MPE患者52例作为A组,TPE患者43例作为B组。比较两组患者一般资料、IGFBP-2和CEA水平,并分析IGFBP-2和CEA水平对MPE与TPE的鉴别诊断价值。结果两组患者性别比较,差异无统计学意义(P>0.05);A组患者年龄大于B组(P<0.05)。A组患者IGFBP-2、CEA水平高于B组(P<0.05)。绘制受试者工作特征(ROC)曲线发现,IGFBP-2鉴别诊断MPE与TPE的曲线下面积(AUC)为0.862〔95%CI(0.808,0.959)〕,当其为8.78μg/L时,灵敏度为65.4%,特异度为94.7%,阳性预测值为90.0%,阴性预测值为66.7%;CEA鉴别诊断MPE与TPE的AUC为0.852〔95%CI(0.780,0.935)〕,当其为16.43μg/L时,灵敏度为63.2%,特异度为100.0%,阳性预测值为90.0%,阴性预测值为90.0%。结论 IGFBP-2和CEA对MPE与TPE的鉴别诊断价值相当,鉴别诊断价值均较高,可互为补充。Objective To analyze the differential diagnostic value of IGFBP-2 and CEA between malignant pleural effusion（ MPE） and tuberculous pleural effusion（ TPE）. Methods From June 2012 to December 2013 in the First Affiliated Hospital of China Medical University,Shengjing Hospital Affiliated to China Medical University and Chest Hospital of Shenyang,a total of 52 patients with MPE were selected as A group,a total of 43 patients with TPE were selected as B group. General information,IGFBP-2 and CEA were compared between the two groups, differential diagnostic value of IGFBP-2 and CEA between MPE and TPE was respectively analyzed. Results No statistically significant differences of gender was found between the two groups（ P 〉 0. 05）,while age of A group was statistically significantly larger than that of B group（ P 〈 0. 05）.IGFBP-2 and CEA of A group were statistically significantly higher than those of control group（ P 〈 0. 05）. ROC curve showed that,AUC of IGFBP-2 in the differential diagnosis between MPE and TPE was 0. 862 〔95% CI（ 0. 808,0. 959） 〕,when it was8. 78 μg / L,the sensitivity was 65. 4%,the specificity was 94. 7%,the positive predictive value was 90. 0%,the negative predictive value was 66. 7%; AUC of CEA in the differential diagnosis between MPE and TPE was 0. 852 〔95% CI（ 0. 780,0. 935） 〕,when it was 16. 43 μg / L,the sensitivity was 63. 2%,the specificity was 100. 0%,the positive predictive value was90. 0%,the negative predictive value was 90%. Conclusion IGFBP-2 and CEA have similar relatively high differentialdiagnostic value between MPE and TPE,can complement each other.

关 键 词：胸腔积液 恶性 结核 胸膜 胰岛素样生长因子结合蛋白质2 癌胚抗原 诊断 鉴别 

分 类 号：R734.3[医药卫生—肿瘤] R521.7[医药卫生—临床医学]