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中国防痨杂志 ›› 2006, Vol. 28 ›› Issue (3): 164-166.

• 论著 • 上一篇    下一篇

IFN-γ、VEGF联合检测在结核性胸腔积液和恶性胸腔积液鉴别诊断中的价值

吕伟1;薛克营2;熊盛道2;陈兆辉1;李东峰3;尹先东4   

  1. 1 武汉市结核病防治所 武汉 430030;2 华中科技大学同济医学院附属同济医院呼吸内科 武汉 430030;3 郧阳医学院附属东风医院 十堰 442008;4 荆州市中心医院 荆州 434020;
  • 出版日期:2006-03-10 发布日期:2006-11-03

Clinical study on the diagnostic value of interferon-γ and vascular endothelial growth factor in differentiating tuberculous pleural effusion from malignant pleural effusion

Lv Wei,Xue Keying,Xiong Shengdao,et al.   

  1. Wuhan Antituberculosis Institute of Hubei Province,Wuhan 430030,China
  • Online:2006-03-10 Published:2006-11-03

摘要: 目的探讨γ-干扰素(IFN-γ)、血管内皮生长因子(VEGF)联合检测在结核性胸腔积液(胸液)和恶性胸液鉴别诊断中的价值。方法以2004年3月—2005年5月住院的87例胸腔积液患者为研究对象,其中结核性胸液45例,恶性胸液42例,应用酶速率法检测胸液中腺苷酸脱氨酶(ADA)的活性,应用ELISA法检测IFN-γ、癌胚抗原(CEA)和VEGF的浓度。应用受试者工作特征曲线(receiver operating characteristic curve,ROC)计算上述指标及VEGF/IFN-γ比值的诊断敏感性、特异性和准确性。结果结核性胸液组ADA和IFN-γ含量高于恶性胸液组,有显著性差异(P<0.01);恶性胸液组CEA、VEGF含量和VEGF/IFN-γ比值高于结核性胸液组,有显著性差异(P<0.01)。IFN-γ对结核性胸液诊断的敏感性和特异性高于ADA;VEGF/IFN-γ比值对恶性胸液诊断的敏感性和特异性高于CEA和VEGF。结论IFN-γ和VEGF/IFN-γ比值可以作为临床上鉴别结核性胸液和恶性胸液的有效指标。

关键词: γ-干扰素, 血管内皮生长因子, 结核, 胸腔积液

Abstract: Objective To evaluate the significance of interferon-γ(IFN-γ) and vascular endothelial growth factor(VEGF) in differentiating tuberculous pleural effusion from malignant pleural effusion.Methods forty-five patients with tuberculous pleural effusion and 42 patients with malignant pleural effusion in Wuhan Antituberculosis Institute,from March 2004 to May 2005,were the study subject.The adenosine deaminase(ADA),IFN-γ,carcinoembryonic antigen(CEA) and VEGF levels of pleural effusion were detected.The sensitivity,specificity and accuracy of ADA,IFN-γ,CEA,VEGF and VEGF/IFN-γ ratio were obtained through ROC.Results The ADA and IFN-γ levels of tuberculous group were significantly higher than that of malignant group(P<0.01),while its CEA,VEGF levels and VEGF/IFN-γ ratio were significantly lower than that of malignant group(P<0.01).The sensitivity and specificity of IFN-γ were higher than that of ADA.The sensitivity and specificity of VEGF/IFN-γ ratio were higher than that of CEA and VEGF.Conclusion IFN-γ and VEGF/IFN-γ ratio could be used as valuable parameters for the differentiation of tuberculous pleural effusion from malignant pleural effusion.

Key words: Interferon-γ, Vascular endothelial growth factor, Tuberculousis, Pleural effusion