11种分枝杆菌抗原用于肺结核和肺癌血清学鉴别诊断的效果比较

Comparison of the effects on the mycobacterial antigen in serological differential diagnosis of pulmonary tuberculosis and lung cancer

目的：对１１种分枝杆菌抗原制备物用于肺结核和肺癌血清学鉴别诊断的效果进行评估。方法：采用ＥＬＩＳＡ技术分别测定１０４例肺结核患者，１０４例肺癌患者和５２例正常人血清中抗１１种分枝杆菌抗原制备物的抗体水平。结果：淋巴分枝杆菌菌体超声抗原Ｂ６ｂ检测肺结核血清抗体阳性率为８２％，显著高于抗ＰＰＤ抗体的阳性率６２％（Ｐ＜０．０５）。Ｂ６ｂ抗原检测肺癌患者血清抗体的阳性率为１．９％，远低于抗ＰＰＤ抗体的阳性检出率１５．４％（Ｐ＜０．０１）。结论：分枝杆菌抗原制备物的菌种来源、细胞培养方法和抗原制备方法对其用于血清学鉴别诊断的灵敏度和特异性，都有重要影响。其中。

Objective:to evaluate the effect about 11 antigenpreparations used for serological differential diagnosis of pulmonary tuberculosis and lung cancer.Methods:With ELISA we measured the antibodies against 11 antigenpreparations in sera from 104 patients with pulmonary tuberculosis, 104 patients with lung cancer and 52 healthy controls respectively. Results:The positive rate of the antibody in sera of patients with pulmonary tuberculosis against Antigen B6b which was a cell ultrasonic prepartion from Mycobacterium scrofulaceum was 82%, which is significantly higher than 62% of positive antibody against PPD (P<0.05);1.9% of sera from lung cancer had positive antibody against B6b and 15.4% of sera from lung cancer had positive antibody against PPD, the difference was very significant (P<0.01).Conclusion:The species, culture method and preparation method of the antigens from Mycobacterium had an important influence on the specificity and sensitivity in serological diagnosis. Among these antigens, B6b gave the best effect in the differential diagnosis.