矿物粉尘诱导基因在恶性和结核性胸腔积液中的表达及临床意义

目的探讨矿物粉尘诱导基因（MDIG）在恶性和结核性胸腔积液中的表达情况及临床意义。方法收集确诊的54例恶性胸腔积液患者（恶性胸腔积液组）和50例结核性胸腔积液患者（结核性胸腔积液组）的胸腔积液标本。采用酶联免疫吸附法检测两组胸腔积液的MDIG蛋白浓度，反转录实时定量聚合酶链反应检测胸腔积液沉渣中的MDIGmRNA表达情况。通过受试者工作特征曲线（ROC曲线）分析，评价MDIG蛋白和MDIGmRNA对诊断恶性胸腔积液的界值、敏感度、特异度等。通过Spearman相关性分析MDIG蛋白和MDIGmRNA的相关性。结果恶性胸腔积液组的MDIG蛋白明显高于结核性胸腔积液组（304．38±228．47）ng／L比（44．43±40．57）ng／L]，差异有统计学意义（P〈0．01）。恶性胸腔积液组MDIGmRNA明显高于结核性胸腔积液组（6．27±3．54比1．82±0．64），差异有统计学意义（P〈0．01）。当诊断界值是114．23ng／L时，MDIG蛋白诊断恶性胸腔积液的敏感度和特异度分别为77．8％和94．0％。当诊断界值是2．75时，MDIGmRNA诊断恶性胸腔积液的敏感度和特异度分别为88．9％和92．0％。在恶性胸腔积液中，MDIG蛋白和MDIGmRNA表达具有相关性（r=0．915，P〈0．01）。结论MDIGmRNA和MDIG蛋白可在恶性胸腔积液中高水平表达，敏感度和特异度都较好。具有潜在诊断恶性胸腔积液的临床应用价值。

The expression and clinical significance of mineral dust.induced gene in malignant and tuberculosis pleural effusion

Objective To investigate the expression and clinical significance of mineral dust-induced gene（MDIG） in malignant pleural effusions （MPE） and tuberculosis pleural effusions （TBPE）. Methods Fifty-four patients with MPE （MPE group） and 50 patients with TBPE （TBPE group） were collected. The MDIG protein was detected by enzyme-linked immunosorbent assay and the relative quantification of MDIG mRNA was measured by real-time quantitation polymerase chain reaction. The cutoff value, sensitivity and specificity of the MDIG protein and MDIG mRNA to diagnose the MPE were evaluated by receiver operating characteristic （ ROC ） curve analysis. By Spearman correlation analysis, the correlation of MDIG protein and MDIG mRNA was evaluated. Results The MDIG protein in MPE group was significantly higher than that in TBPE group （304.38 ± 228.47 ） ng/L vs. （44.43± 40.57 ） ng/L], and there was statistical difference （P 〈 0.01 ）. The MDIG mRNA in MPE group was significantly higher than that in TBPE group （6.27 ± 3.54 vs. 1.82± 0.64）,and there was statistical difference （P 〈 0.01 ）. With a cutoff point of 114.23 ng/L,MDIG protein had a sensitivity of 77.8% and a specificity of 94.0% for differential diagnosis. With a cutoff point of 2.75, MDIG mRNA had a sensitivity of 88.9% and a specificity of 92.0% fordifferential diagnosis. There was a positive correction between MDIG protein and MDIG mRNA （r = 0.915, P 〈 0.01 ）. Conclusions The MDIG protein and MDIG mRNA are highly expressed in MPE with a good sensitivity and specificity. MDIG protein and MDIG mRNA maybe a good clinical indicator in the diagnosis of malignant pleural effusions.