TXNIP和CEA联合检测对良恶性胸腔积液的诊断价值

Diagnostic value of TXNIP and CEA combined detection in differentiating between benign and malignant pleural effusion

目的探讨硫氧还蛋白结合蛋白(TXNIP)、癌胚抗原(CEA)联合检测在良、恶性胸腔积液鉴别诊断中价值。方法收集57例胸腔积液患者(良性32例,恶性25例)的临床资料,采用ELISA法测定血清和胸腔积液中TXNIP和CEA浓度水平。结果恶性胸腔积液中TXNIP浓度明显低于良性胸腔积液中的含量;良恶性胸腔积液患者的血清中TXNIP浓度水平差异无统计学意义。TXNIP浓度89.57μg/L为最佳临界值,恶性胸腔积液的诊断灵敏度76%,特异度87.5%,符合率86.96%;CEA浓度5.285μg/L为最佳临界值,恶性胸腔积液的诊断灵敏度88%,特异度90.6%,符合率91.23%。联合试验,并联诊断的灵敏度为97.12%,特异度为79.28%;串联诊断灵敏度为66.88%,特异度98.83%。结论 TXNIP对恶性胸腔积液的诊断具有一定价值,与CEA联合检测可以提高诊断灵敏度与特异度。但是TXNIP对恶性胸腔积液的诊断价值并不优于CEA。

Objective To explore the diagnostic value of combined detection by thioredoxin-interacting protein （ TXNIP） and carcinoembryonic antigen （ CEA） in discriminating between benign and malignant pleural effusion. Methods The clinical data of 57 patients were collected from 25 cases of malignant pleural effusion and 32 of be-nign pleural effusion. The levels of TXNIP, CEA in serum and pleural effusion were measured by enzyme linked immunosorbent assay （ ELISA） . Results The concentrations of TXNIP in patients with malignant pleural effusion were significantly lower than those patients in benign pleural effusion. But the difference in serum was not statisti-cally significant between benign group and malignant group. Diagnostic sensitivity, specificity and agreement rate for TXNIP in malignant pleural effusion were 76%, 87. 5% and 86. 96% respectively at diagnostic cut-off point of 89. 57 μg/L, 88%, 90. 6% and 91. 23% for CEA at 5. 285 μg/L. Diagnostic sensitivity and specificity value were 97. 12%, 79. 28% respectively in parallel test, and 66. 88%, 98. 83% in serial test. Conclusion The de-tection of TXNIP has certain value to the diagnosis of malignant pleural effusion, and joint detection with CEA can improve the diagnostic sensitivity and specificity value. However, the diagnostic value of TXNIP to malignant pleu-ral effusion is not superior to CEA.