胸腹水LMR、EOS、LDH联合检测对良恶性胸腹腔积液的鉴别诊断价值  

The Value of Lmr,Eos and Ldh Combined Detection in Differential Diagnosis of Benign and Malignant Pleuroperitoneal Effusion

作　　者：文柯 王琼[1] 靳德甫 李畅 嵇金陵 WEN Ke;WANG Qiong;JIN Defu;LI Chang;JI Jinling(Department of Clinical Laboratory,The First Affiliated Hospital of Huaian,Nanjing Medical University,Huaian,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院检验科,江苏淮安223300

出　　处：《转化医学杂志》2025年第3期56-60,共5页Translational Medicine Journal

基　　金：南京医科大学科技发展基金(NMUB2019357)。

摘　　要：目的探讨胸腹水淋巴细胞-单核细胞比值(LMR)、嗜酸性粒细胞(EOS)、乳酸脱氢酶(LDH)联合检测对良恶性胸腹腔积液的鉴别诊断价值。方法选取2021年10月至2023年9月南京医科大学附属淮安第一医院检验科收治的252例胸腹腔积液患者作为研究对象,采用病例对照研究法,将手术病理确诊良性病变患者作为良性组(123例),确诊癌症患者作为恶性组(129例)。采用全自动血细胞分析仪检测胸腹水淋巴细胞、单核细胞、EOS,并计算LMR,采用生化分析仪检测胸腹水LDH。采用受试者工作特征(ROC)曲线分析胸腹水LMR、EOS、LDH对良恶性胸腹腔积液的诊断价值。结果良性组患者胸腹水LMR、EOS、LDH明显低于恶性组,差异有统计学意义(P<0.05)。胸腹水LMR、EOS、LDH诊断良恶性胸腹腔积液的曲线下面积(AUC)分别为0.814、0.753、0.619,联合3项指标诊断的AUC为0.938。胸腹水LMR在诊断恶性胸腹腔积液的特异度最高,达到0.659,其次为EOS和LDH,分别为0.618、0.577;胸腹水LDH在诊断恶性胸腹腔积液的敏感度最高,达到0.860,其次为EOS和LMR,分别为0.760、0.744;联合3项指标联合诊断的特异度和敏感度可达到0.886和0.915。结论胸腹水LMR、EOS及LDH联合检测鉴别良恶性胸腹腔积液有较高的临床价值。Objective To investigate the value of combined determination of lymphocyte-to-monocyte ratio(LMR),eosinophilic granulocyte(EOS)and lactate dehydrogenase(LDH)in the differential diagnosis of benign and malignant pleuroperitoneal effusions.Methods A total of 252 patients with pleuroperitoneal effusions admitted to our hospital from October 2021 to September 2023 were selected as the subjects,123 patients with benign lesions confirmed by surgical pathology were selected as the benign group,and 129 patients with cancer were selected as the malignant group by case-control study.A fully automated blood cell analyzer was used to detect lymphocytes,monocytes,and EOS in pleural or peritoneal fluid,with LMR calculated.A biochemical analyzer to detect LDH was used in pleural and peritoneal fluid.The diagnostic value of LMR,EOS and LDH in benign and malignant pleuroperitoneal effusion were evaluated by receiver operating characteristic(ROC)curves.Results The LMR,EOS and LDH levels in the benign group were lower than those in the malignant group(P<0.05).The AUCs of LMR,EOS and LDH in the diagnosis of benign and malignant pleuroperitoneal effusions were 0.814,0.753 and 0.619,respectively,and the AUC of the combined diagnosis was 0.938.The specificity of pleural fluid LMR in the diagnosis of malignant pleural fluid was the highest(0.659),followed by EOS and LDH(0.618 and 0.577,respectively).LDH had the highest sensitivity in the diagnosis of malignant pleuroperitoneal effusion(0.860),followed by EOS and LMR(0.760 and 0.744,respectively).The diagnostic specificity and sensitivity of the three indexes combined can reach 0.886 and 0.915.Conclusion The combined detection of LMR,EOS and LDH in pleural and abdominal fluid has high clinical value for differential diagnosis of benign and malignant pleural and abdominal effusions.

关 键 词：淋巴细胞-单核细胞比值 嗜酸性粒细胞 乳酸脱氢酶 恶性胸腹腔积液 

分 类 号：R446.1[医药卫生—诊断学]