D-二聚体在恶性胸腔积液的表达及临床意义  

Expression of D-dimer in malignant pleural effusion and its diagnostic value

作　　者：朱洪斌[1] ZHU Hongbin(Department of Respiratory Medicine,The Affiliated Chaohu Hospital of Anhui Medical University,Hefei,Anhui 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院呼吸内科,安徽合肥238000

出　　处：《安徽医药》2019年第6期1179-1182,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨D-二聚体在恶性胸腔积液中的表达及临床意义。方法收集2016年1月至2018年7月安徽医科大学附属巢湖医院64例胸腔积液病人资料。采用免疫比浊法检测31例恶性胸腔积液病人和33例良性胸腔积液病人血浆和胸腔积液D-二聚体的表达,探讨D-二聚体的表达差异及诊断恶性胸腔积液的价值。结果恶性胸腔积液组病人胸液和血浆中D-二聚体的表达水平高于对照组(P<0.05),两者比值同样较对照组增高(P<0.05)。根据受试者工作特征曲线以胸液D-二聚体4.34μg/mL为最佳cut-off值,其灵敏度为88.1%,特异度为83.4%;取胸液与血浆D-二聚体的比值为4.37,其灵敏度和特异度分别为86.4%和89.1%。选择胸液与血浆D-二聚体比值联合胸液癌胚抗原联合检测,其灵敏度为83.7%,特异度为93.2%。结论 D-二聚体在恶性胸腔积液中的表达水平较高,与癌胚抗原联合检测可提高恶性胸腔积液的诊断灵敏度及特异度,D-二聚体可作为诊断恶性胸腔积液的标志物。Objective To explore the expression of D-dimer in malignant pleural effusion(MPE)patients and its diagnostic value.Methods Data of 64 patients with pleural effusion were recruited,who were treated in The Affiliated Chaohu Hospital of Anhui Medical University from January 2016 to July 2018.The expressions of D-dimer in plasma and pleural effusion were detected in 31 malignant pleural effusion(MPE)cases and 33 benign pleural effusion patients by immuno-turbidimetric method.Results The expressions of D-dimer in plasma and pleural effusion in MPE group were significantly higher than those in the control group(P<0.05).The plasma/pleural effusion D-dimer ratio in MPE group was also higher than that in the control group(P<0.05).According to receiver operating characteristic curve(ROC),the cut-off value for D-dimer was defined at 4.34μg/mL.The sensitivity and specificity of D-dimer were 88.1%and 83.4%,respectively.The plasma D-dimer to pleural effusion D-dimer ratio was defined at 4.37.The sensitivity and specificity were 86.4%and 89.1%,respectively.And the sensitivity and specificity of combined measurement with pleural effusion carcinoembryonic antigen(CEA)increased to 83.7%and 93.2%,respectively.Conclusion The expression of D-dimer in MPE is higher than that in benign pleural effusion,and the combined detection of D-dimer and CEA can improve the diagnostic sensitivity and specificity significantly,so D-dimer could be used as a biomarker for the diagnosis of MPE.

关 键 词：D-二聚体 胸腔积液 肺癌 肿瘤 

分 类 号：R730.43[医药卫生—肿瘤]