CD1a分子和IFN-γ因子对良恶性胸腔积液诊断价值

DIAGNOSTIC VALUE OF CD1a A ND IFN-γ IN TUBERCULOUS AND MALIGNANT PLEURAL EFFUSION

①目的探讨结核性、恶性肿瘤性胸腔积液中的免疫分子CD1a和细胞因子干扰素Ⅱ型(IFN-γ)的变化,及其对两种胸腔积液的鉴别诊断价值。②方法采用流式细胞仪(FCM)和酶联免疫吸附试验(ELISA)分别检测34例结核性、31例恶性肿瘤性胸腔积液病人胸腔积液中的CD1a+细胞数和IFN-γ的含量。③结果恶性肿瘤性胸腔积液中CD1a阳性率明显高于结核性胸腔积液,IFN-γ的含量明显低于结核性胸腔积液(t=21.00、26.00,P<0.001)。以CD1a阳性率6%为临界值,对恶性胸腔积液诊断的灵敏度和特异度分别为90%和88%,约登指数为78%;以IFN-γ含量300μg/L为临界值,对结核性胸腔积液诊断的灵敏度和特异度分别为97%和94%,约登指数为91%。④结论胸腔积液中CD1a阳性率和IFN-γ含量可作为良、恶性胸腔积液鉴别诊断的参考依据。

Objective To analyze the changes of CDla and IFN-γ in pleural effusion in patients with tuberculosis and malignant tumors, and to find a possible way to differentiate them. Methods Thirty-four patients with tuberculosis and 31 with malignant tumors were separately detected by Flow Cytometer （FCM） with fluorescence labeling monoclonal antibody CDla and Enzyme-Linked Immunosorbent Assay （ELISA） to assay the CD1a^＋ and the content of IFN-γ in the two pleural effusions. Results The CD1a^＋ was significantly higher in malignant effusion than in tuberculous （t=21.00,P〈0. 001） ; the content of IFN-γ in tuberculous effusion was higher than in malignant （t= 26.00, P〈0. 001）. The sensibility and specificity of diagnosis in tumor effusion with CD1a^＋ based on six percent were 90% and 88%, respectively; the Youden＇s Index was 78%. The IFN-γ 300μg/L was as one baseline, the sensibility and specificity for tuberculosis were 97 % and 94% respectively; the Youden＇s Index was 91%. Conclusion The CD1a^＋ and the content of IFN-γ are useful in the differential diagnosis of the two different pleural effusions.