可溶性CD40在在良恶性胸腔积液鉴别诊断中的价值

The role of soluble CD40 in diagnosis of benign and malignant pleural effusion

目的 探讨中可溶性CD40(sCD40)浓度水平在良恶性胸腔积液鉴别中的价值.方法 回顾性分析我院2016年1月至2017年12月间收治胸腔积液患者共98例,其中良性胸腔积液患者48例,恶性胸腔积液患者50例,采用酶联免疫吸附法(ELISA)检测胸腔积液中sCD40的浓度水平,以受试者工作曲线(ROC)分析可溶性CD40(sCD40)浓度水平在胸腔积液良恶性鉴别中的价值.结果 恶性胸腔积液组中sCD40平均浓度为(248.6±20.8)pg/ml,明显高于良性胸腔积液组[(105.8±19.3)pg/ml],且差异有统计学意义(P<0.05).sCD40诊断恶性胸腔积液的最佳临界值为121.6 pg/ml,特异度、敏感度、准确度分别为81.3%、90.0%、85.7%.相关性分析表明,sCD40表达与年龄正相关(r=0.673,P<0.05),与性别、胸腔积液类型无关(P>0.05).结论 sCD40在恶性胸腔积液中高表达,对良性及恶性胸腔积液的鉴别诊断具有重要价值.

Objective To investigate the role of soluble CD40(sCD40)levels in differential diagnosis of benign and malignant pleural effusion.Methods Ninety-eight patients with pleural effusion admitted to our hospital between January 2016 and December 2017 were retrospectively analyzed,including 48 patients with benign and 50 with malignant pleural effusion.Enzyme-linked immunosorbent assay(ELISA)was used to examine the levels of sCD40 in the pleural effusion.Receiver operating curve(ROC)was used to analyze the role of sCD40 concentration levels in distinguishing benign and malignant pleural effusion.Results The mean level of sCD40 in the malignant pleural effusion group was(248.6±20.8)pg/ml,which was significantly higher than that in the benign pleural effusion group[(105.8±19.3)pg/ml],with statistically significant difference(P<0.05).The optimal cut-off value of sCD40 for diagnosing malignant pleural effusion was 121.6 pg/ml.The specificity,sensitivity and accuracy were 81.3%,90.0%and 85.7%,respectively.Correlation analysis showed that the level of sCD40 had a positive correlation with age(r=0.673,P<0.05),and had no correlation with gender and pleural effusion type(P>0.05).Conclusion sCD40 is highly expressed in malignant pleural effusion,which is of great value in the differential diagnosis of benign and malignant pleural effusion.