血管内皮细胞生长因子C与腺苷脱氨酶联合检测在胸腔积液鉴别诊断中的意义

目的 了解血管内皮细胞生长因子C(VEGF-C)及腺苷脱氨酶(ADA)在不同原因胸腔积液中的表达,并探讨通过比值构建联合诊断对胸腔积液鉴别诊断的作用.方法 选择143例临床确诊的胸腔积液患者(恶性胸腔积液40例,结核性胸膜炎45例,其他类型58例),采用双抗夹心ELISA法检测胸水VEGF-C,采用速率法检测胸水ADA,计算VEGF-C/ADA比值,比较不同类型胸腔积液患者中上述诊断指标的变化,并计算它们的敏感度、特异度和准确度.结果 恶性胸腔积液中VEGF-C浓度高于结核性胸腔积液及类肺炎性等其他类型胸腔积液,(286.32±102.65)ng/L vs(133.46±39.83)ng/L,(140.14±44.62)ng/L,P<0.05.结核性胸腔积液中ADA浓度高于恶性胸腔积液及其他类型胸腔积液,(78.6±36.3)IU/L vs(23.4±11.2)IU/L,(26.1±10.5)IU/L,P<0.05.VEGF-C/ADA≥8对恶性胸腔积液诊断的敏感度为87.5%,特异度为81.4%;VEGF-C/ADA≤3对结核性胸腔积液诊断的敏感度为84.4%,特异度为86.4%.结论 VEGF-C与ADA浓度比值对胸腔积液的鉴别诊断具有较好的临床价值.

Role of vascular endothelial growth factor C combined with adenosine deaminuse in differential diagnosis of pleural effusion

Objective To analyze the expressions of vascular endothelial growth factor C (VEGF-C) and adenosine deaminase(ADA)in different kinds of pleural effusions, and approach the role of combination diagnosis in the differential diagnosis of pleural effusions. Methods The concentrations of VEGF-C and ADA were detected in pleural effusion samples from 143 clinical confirmed patients (40 cases of malignant pleural effusion, 45 cases of tuberculous pleural effusion, 58 cases of inflammatory and other pleural effusion) in order to assess their sensitivity, specificity, accuracy. Moreover, the value of VEGF-C/ADA was calculated and utilized to distinguish different kinds of pleural effusions. ResultsVEGF-C concentration in malignant pleural effusion was higher than that in tuberculous pleural effusion and inflammatory and other pleural effusion,(286.32±102.65) ng/L vs (133.46±39.83) ng/L,(140.14± 44.62) ng/L, P <0.05. ADA concentration in tuberculous pleural effusion was higher than that in malignant pleural effusion and inflammatory and other pleural effusion, (78.6±36.3) IU/L vs (23.4± 11.2) IU/L, (26.1±10.5) IU/L, P <0.05. VEGF-C/ADA≥8 might indicate malignant pleural effusion (sensitivity 87.5%, specificity 81.4%), and VEGF-C/ADA≤3 probably indicated tuberculous pleural effusion(sensitivity 84.4%, specificity 86.4%). Conclusions The concentration ratio of VEGF-C and ADA is of clinical diagnosis value in differential diagnosis of pleural effusions.