胸腹腔积液细胞形态及计数联合腺苷脱氨酶检测对结核性浆膜炎的诊断效能

目的探讨胸腹腔积液中各种细胞形态及计数联合腺苷脱氨酶（ADA）检测对结核性浆膜炎的诊断价值,采用受试者工作特征（ROC）曲线和Logistic回归评价其价值。 方法选取2018年6月至2019年6月临床病例328例（包括结核组177例,非结核组151例）,进行浆膜腔常规细胞形态学各指标分析及ADA检测,建立Logistic回归模型,并绘制ROC曲线评价其预测效能。 结果最终纳入模型的指标包括：有核细胞数量（×10⁶/L）、淋巴细胞比例（%）、淋巴细胞数量（×10⁶/L）、间皮细胞比例（%）、间皮细胞数量（×10⁶/L）、ADA（mg/L）、异型淋巴细胞/淋巴母细胞、核异质间皮细胞共8项指标,Logistic回归模型联合检测ROC曲线下面积为0.971［95%CI（0.955~0.986）］,敏感度和特异度分别为90.0%,94.0%,均高于单项检测。 结论浆膜腔常规细胞形态学分析联合ADA检测回归模型的建立对结核性浆膜炎具有较高的预测准确性及临床实用性。

Diagnostic value of serous effusion cell morphology and count combined with adenosine deaminase test in tuberculous serous membrane inflammation

ObjectiveTo explore the diagnostic value of serous effusion cell morphology and count combined with adenosine deaminase (ADA) test for tuberculous serous membrane inflammation, and evaluate its application by receiver operating characteristic (ROC) curve analysis and Logistic regression. MethodsA retrospective analysis was performed on 328 clinical cases (including 177 cases in the tuberculosis group and 151 cases in the non-tuberculosis group) from June 2018 to June 2019. All standard cytology and ADA tests were performed, Logistic regression model was established, and ROC curve was plotted to evaluate its predictive efficacy. ResultsIndicators that were eventually incorporated into the model included the number of nucleated cells (×10⁶/L), lymphocyte percentage (%), the number of lymphocytes (×10⁶/L), mesothelial cell percentage (%), mesothelial cell number (×10⁶/L), ADA (mg/L), abnormal lymphocytes or lymphoid cells, and nuclear heterogeneous mesothelial cells. Logistic regression analysis showed that the area under the ROC curve of combined detection was 0.971 [95% CI (0.955-0.986)], and the sensitivity and specificity were 90.0% and 94.0%, respectively, all of which were higher than those of single detection. ConclusionCell morphology combined with ADA detection can predict tuberculous serous membrane inflammation with high accuracy and clinical practicability.