VEGF、CD44_(V6)、MMP联合检测对良、恶性胸水的鉴别意义

The Differential diagnostic meaning of VEGF, CD44_(V6), MMP combined test in pleural effusions

目的:探讨CD44V6、VEGF、MMP2、MMP9单项和联合检测在良恶性胸腔积液性质鉴别诊断中的价值。方法:选取60名胸腔积液患者,30例为恶性胸腔积液,30例为良性胸腔积液。抽取胸腔积液后,采用ELISA方法分别进行VEGF、CD44V6、MMP2、MMP9检测。结果:在单项检测指标中,VEGF的诊断效能最好,其诊断分界点为181.1pg/ml,敏感性为90.0%,特异性为86.7%。联合检测中,以(VEGF+CD44V6)和(VEGF+MMP2)的诊断效能较好。VEGF+CD44V6联合检测的敏感性为83.3%,特异性为90.0%。VEGF+MMP2联合检测的敏感性为80.0%,特异性93.3%。结论:恶性胸腔积液中的VEGF、CD44V6、MMP2、MMP9水平明显高于良性胸腔积液。单项检测中VEGF有较高的敏感性和特异性;联合检测以VEGF+CD44V6和VEGF+MMP2的敏感性和特异性为最高。

Objective：To observe the diagnostic value of VEGF, CD44V6, MMP2, MMP9 and their combined examination in distinguishing malignant pleural effusion from benign one. Methods：Sixty patients with pleural effusions were observed, thirty ofthemsufferred from malignant pleura1 effusion andthirtyof them sufferred from benign one. The expression of CD44V6, VEGF, MMP2, MMP9 in the pleural effusion were tested with ELISA technique. Results ： As single-item detection, the diagnosetic value of VEGF is the best, the cutoff of VEGF was 181.1pg/ml, the sensitivity of VEGF examination was 90.0%, the specificity was 86.7%. The sensitivity and the specificity of combined examination VEGF＋CD44V6 and VEGF＋MMP2 were the best, the sensitivity of VEGF＋CD44V6 was 83.3%, the specificity was 90.0%. The sensitivity of VEGF＋MMP2 was 80.0%, the specificity was 93.3%. Conclusion：The level of VEGF, CD44V6, MMP2, MMP9 in malignant pleural effusion is clearly higher than that in benign pleura1 one. VEGF has higher sensitivity and specificity. As combined examination, VEGF＋CD44V6 and VEGF＋MMP2 have higher sensitivity and specificity.