血清和胸水中HE4在肺癌恶性胸腔积液诊断中的价值分析

An Analysis on the Diagnostic Value of HE4 in Serum and PleuralEffusion for Malignant Pleural Effusion of Lung Cancer

目的探讨血清和胸水中HE4对肺癌恶性胸腔积液的诊断价值。方法选取我院确诊的肺癌恶性胸腔积液患者30例为肺癌组和肺炎伴胸腔积液患者30例为良性组,检测两组患者血清和胸水中HE4水平及两指标比值。分析肺癌恶性胸腔积液患者血清及胸水中HE4表达的差异及相关性,应用ROC曲线确定胸水/血清中HE4比值(p-HE4/s-HE4)对两组鉴别的临界值,观察其对肺癌恶性胸腔积液的诊断特异性、灵敏度及准确性。结果肺癌组胸水HE4[2249.50(639.80-4627.75)]pmol/L、血清HE4[165.30(98.03-264.80)]pmol/L和p-HE4/s-HE4比值为[8.64(4.73-15.01)]均高于良性组胸水HE4[372.30(273.23-441.38)]pmol/L、血清HE4[107.40(89.30-149.80)]pmol/L和p-HE4/s-HE4比值[2.93(2.15-4.33)],差异均有统计学意义(P<0.05)。肺癌组胸水中HE4水平明显高于血清中水平,差异有统计学意义。通过Spearman相关分析,发现胸水与血清HE4表达存在相关性(r=0.640,P<0.001),但是密切程度不高。p-HE4/s-HE4>5.45在两组中的比率差异有统计学意义(χ^(2)=31.093,P<0.001),采用ROC曲线确定p-HE4/s-HE4=5.45为临界值,对肺癌恶性胸腔积液诊断的灵敏度可达到73%,特异性为97%。结论患者血清、胸水HE4水平与p-HE4/s-HE4比值对肺癌恶性胸腔积液具有一定的临床诊断价值。

Objective To investigate the diagnostic value of HE4 in serum and pleural effusion for lung cancer.Methods 30 cases of pleural effusion were selected as the lung cancer group,while 30 cases of pneumonia patients were selected as the benign group.We analyzed the difference and correlation of HE4 expression in serum and pleural effusion.ROC curve was drawn to determine the critical value of p-HE4/s-HE4 in the differential diagnosis between the two groups,and the diagnostic specificity,sensitivity and accuracy of p-HE4/s-HE4 in lung cancer were obtained.Results The pleural effusion HE4[2249.50(639.80-4627.75)]pmol/L,serum HE4[165.30(98.03-264.80)]pmol/L and p-HE4/s-HE4 ratio of the cancer group were higher than those of the benign group,which had pleural effusion HE4[372.30(273.23-441.38)]pmol/L,serum HE4[107.40(89.30-149.80)]pmol/L and p-HE4/s-HE4 ratio[2.93(2.15-4.33)](P<0.05).The level of HE4 in pleural effusion of the cancer group was significantly higher than that in serum.Spearman correlation analysis showed that there was a correlation between pleural effusion and serum HE4 expression(r=0.640,P<0.001),but the correlation degree was not high.The difference of p-HE4/s-HE4 was greater than 5.45 between the two groups.The critical value of p-HE4/s-HE4=5.45 determined by ROC curve were 73%and 97%,respectively.Conclusion Serum and pleural fluid HE4 levels and p-HE4/s-HE4 ratio have certain clinical diagnostic values for malignant pleural effusion of lung cancer.