白细胞介素27在结核性胸腔积液和恶性胸腔积液鉴别诊断中的价值

目的研究胸腔积液中白细胞介素27(IL-27)浓度对于结核性胸腔积液(TPE)和恶性胸腔积液(MPE)的鉴别诊断价值.方法纳入2015~2018年收住北京朝阳医院诊断为TPE或MPE的患者,通过酶联免疫吸附法测定胸腔积液及血浆中IL-27浓度.通过受试者工作特征曲线获取胸腔积液中IL-27的浓度、胸腔积液与血浆IL-27浓度的差值和比值的诊断价值.结果143例患者中TPE组78例,MPE组65例.TPE患者中胸腔积液IL-27浓度显著高于MPE患者,胸腔积液IL-27诊断TPE的诊断界值为499.71 ng/L,敏感度为93.6%,特异度为95.4%,曲线下面积为0.952(95%CI:0.913~0.991),Z统计分析显示,胸腔积液与血浆IL-27浓度差值和比值的诊断价值不高于胸腔积液IL-27浓度.结论胸腔积液IL-27浓度是鉴别TPE和MPE的理想生物标志物.

Diagnostic value of interleukin-27 level in differentiating tuberculous pleural effusion from malignant pleural effusion

Objective To explore the diagnostic value of interleukin-27(IL-27)in pleural effusion to distinguish between tuberculous pleural effusion(TPE)and malignant pleural effuvsion(MPE).Methods Patients diagnosed with TPE or MPE who were treated at Beijing Chaoyang Hospital from 2015 to 2018 were included.The concentration of IL-27 in pleural effusion and plasma were measured by enzyme-linked immunosorbent assay.The diagnostic value of concentration of the IL-27 in pleural effusion,the difference and ratio between the concentration of IL-27 in pleural effusion and serum were obtained by standard receiver operating characteristic curves.Results A total of 143 patients,78 in the TPE group and 65 in the MPE group.The concentration of IL-27 in PE of TPE patients was significantly higher than that of MPE patients.The diagnostic cutoff value of pleural effusion IL-27 for TPE was 499.71 ng/L,t h e sensitivity was 93.6%,the specificity was 95.4%,and the area under the curve was 0.952(95%CI:0.913-0.991),Z statistical analysis showed that the diagnostic value of the difference and ratio of pleural effusion and plasma IL-27 concentration was not higher than that of IL-27 in pleural effusion.Conclusions The pleural effusion IL-27 concentration could be an ideal biomarker to distinguish TPE and MPE.