VEGF、EGFR及CD40检测在鉴别良恶性胸腔积液中的价值  

Value of detection of VEGF,EGFR and CD40 in differential diagnosis of benign and malignant pleural effusion

作　　者：丁彦[1] 周建荣[1] 帅萍 廖长风[3] 王颖[1] 袁小亮[1] DING Yan;ZHOU Jianrong;SHUAI Ping;LIAO Changfeng;WANG Ying;YUAN Xiaoliang(Department of Respiration,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China;Department of Pathology,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China;Blood Laboratory,the First Affiliated Hospital of Gannan Medical University,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院呼吸科,江西赣州341000 [2]赣南医学院第一附属医院病理科,江西赣州341000 [3]赣南医学院第一附属医院血液实验室,江西赣州341000

出　　处：《中国医药导报》2019年第20期141-144,共4页China Medical Herald

基　　金：江西省卫生计生委科技计划项目(20175346)

摘　　要：目的探讨血管内皮生长因子(VEGF)、表皮生长因子(EGFR)及CD40检测在鉴别良恶性胸腔积液中的价值。方法选取2015年6月~2017年6月于赣南医学院第一附属医院住院并确诊为肺癌合并胸腔积液的患者60例为观察组,选取同期住院的结核性胸膜炎合并胸腔积液的患者60例为对照组,检测所有患者的胸腔积液标本,并比较两组VEGF、EGFR及CD40的表达水平,采用受试者工作特征曲线(ROC)分析各项指标对恶性胸腔积液的诊断价值。结果观察组胸腔积液中VEGF、EGFR及CD40的表达水平显著高于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,VEGF诊断恶性胸腔积液的曲线下面积为0.840,以893.50pg/mL为截点值,敏感性为70.00%,特异性为91.70%。EGFR诊断恶性胸腔积液的曲线下面积为0.839,以29.50mg/L为截点值,敏感性为80.00%,特异性为88.30%。CD40诊断恶性胸腔积液的曲线下面积为0.911,以41.50pg/mL为截点值,敏感性为85.00%,特异性为93.30%。CD40对良恶性胸腔积液的诊断效能优于VEGF、EGFR。结论恶性胸腔积液中VEGF、EGFR及CD40的表达水平显著增高,三者对良恶性胸腔积液的鉴别均有一定的诊断价值,但CD40诊断恶性胸腔积液的敏感性及特异性均高于VEGF、EGFR。Objective To explore the value of detecting vascular endothelial growth factor (VEGF),epidermal growth factor (EGFR) and CD40 in differential diagnosis of benign and malignant pleural effusion.Methods Sixty patients with lung cancer and pleural effusion hospitalized and diagnosed in the First Affiliated Hospital of Gannan Medical University from June 2015 to June 2017 were selected as observation group.60 tuberculous pleurisy patients with pleural effusion in the same period were selected as control group.The expression levels of VEGF,EGFR and CD40 in pleural effusion samples of all patients were detected and compared between two groups.The diagnostic value of each index for malignant pleural effusion was analyzed by receiver operating characteristic curve (ROC).Results The expression level of VEGF,EGFR and CD40 in pleural effusion of observation group was significantly higher than those of control group,the difference was statistically significant (P < 0.05).ROC curve analysis showed that the area under the curve of VEGF in the diagnosis of malignant pleural effusion was 0.840,with 893.50 pg/mL as the cut-off point,the sensitivity was 70.00%,and the specificity was 91.70%.The area under the curve of EGFR in the diagnosis of malignant pleural effusion was 0.839,and the cut-off point was 29.50 mg/L.The sensitivity was 80.00% and specificity was 88.30%.The area under the curve of CD40 in the diagnosis of malignant pleural effusion was 0.911,and the cut-off point was 41.50 pg/mL.The sensitivity was 85.00% and the specificity was 93.30%.The diagnostic efficiency of CD40 in benign and malignant pleural effusion was better than that of VEGF and EGFR.Conclusion The expression of VEGF,EGFR and CD40 in malignant pleural effusion is significantly increased,the three methods have certain diagnostic value in differentiating benign and malignant pleural effusion.However,the sensitivity and specificity of CD40 in the diagnosis of malignant pleural effusion is higher than that of VEGF and EGFR.

关 键 词：良恶性胸腔积液 鉴别诊断 血管内皮生长因子 表皮生长因子 CD40 

分 类 号：R561.3[医药卫生—呼吸系统]