摘要
目的 探讨腺苷脱氨酶(ADA)、γ干扰素(IFNγ)、癌胚抗原(CEA)对诊断结核性、恶性胸腔积液(简称胸液)的价值。方法 对67例胸液患者同步测定血清、胸液ADA、IFNγ、CEA水平。ADA采用改进的Giusti法,IFNγ采用双抗体夹心ELISA法,CEA采用放免法。结果 结核性胸液组胸液ADA、IFNγ水平与恶性胸液组差异有显著性(P<0.001),恶性胸液组血清和胸液CEA水平与结核性胸液组差异有显著性(P<0.05)。ADA(阳性界值≥40U/L)、IFNγ(≥140pg/mL)对诊断结核性胸液的敏感度分别是88%、96%,特异度分别是85.71%、97.62%,诊断指数分别是73.71%、93.62%。胸液中ADA、IFNγ水平无明显升高,而CEA水平明显升高者联合试验对诊断恶性胸液的特异度是90.64%。结论 检测胸液ADA、IFNγ。
Objective To study the roles of adenosine deaminase(ADA), interferon gamma(IFN γ) and carcinoembryonic antigen(CEA) for diagnosis of tuberculous and neoplastic pleural effusion. Methods ADA, IFN γ and CEA activity in the serum and pleural fluid were detected in 67 patients with pleural effusion by the method of Guisti, a solid phase enzyme immunoassay employing the multiple antibody sandwich principle, and radioimmunoassay respectively.Results The mean ADA and IFN γ concentration in the tuberculous pleural effusion differed significantly from those in the neoplastic pleural effusion (P<0.001). The mean CEA concentration in the serum and pleural fluid with the neoplastic pleural effusion differed from those with the tuberculous pleural effusion (P<0.05). The sensitivity of ADA (with a diagnostic threshold of 40 U/L) and IFN γ(threshold of 140 pg/mL) for tuberculosis was 88% and 96% respectively, the specificity was 85.71% and 97.62%, and diagnostic index was 73.71% and 93.62% . Using the ADA (with below 40 U/L) and IFN γ (below 140 pg/mL) and CEA (above 15 μg/L), we achieved a specificity of 95.95% for diagnosis of neoplastic pleural effusion. Conclusion ADA, IFN γ and CEA are useful parameters in differential diagnosis of tuberculous and neoplastic pleural effusion.
关键词
胸腔积液
结核性
恶性
鉴别
ADA
TNFγ
CEA
Tuberculous pleural effusion Neoplastic pleural effusion Adenosine deaminase Interferon gamma Carcinoembryonic antigen
