IL-18检测在结核性和恶性胸腔积液鉴别诊断中的价值

Value of IL-18 in Differential Diagnosis of Tubercular and Malignant Pleural Effusion

目的探讨胸腔积液中白细胞介素18(IL-18)的检测在结核性和恶性胸腔积液鉴别诊断中的临床价值。方法以2007年8月—2008年7月住院的95例胸腔积液患者为研究对象,其中结核性胸腔积液45例,恶性胸腔积液50例,应用酶联免疫吸附试验(ELISA)法检测胸腔积液标本中IL-18浓度。结果结核性胸腔积液组IL-18的浓度为(1200.34±530.25)pg/ml,恶性胸腔积液组IL-18的浓度为(240.40±80.49)pg/ml,结核性胸腔积液组IL-18的浓度显著高于恶性胸腔积液组(P<0.01);ROC曲线分析结果显示IL-18以360pg/ml为诊断结核性胸腔积液的临界值,其敏感度和特异度分别是89.2%和93.5%。结论胸腔积液中IL-18浓度可以作为鉴别诊断结核性胸腔积液和恶性胸腔积液的有效参考指标。

[ Objective] To investigate the clinical value of the interleukin 18 （IL-18} in differential diagnose the tubercular pleural effusion and the malignant pleural effusion. [ Methods]Totally 95 inpatients with pleural effusion （45 cases with tubercular pleural effusion, 50 cases with malignant pleural effusion ） from August 2007 to July 2008 were selected as object. ELISA was used to detect the concentration of IL-18 in pleural effusion samples. [ Results] The concentration of IL-18 in tubercular pleural effusion group was [ 1200.34± 530.25 ） pg/ml, while that of the malignant pleural effusion group was [ 240.40 ± 80.49 ） pg/ml, the former was signifi- cantly higher than the latter[ P 〈0.01 } ; The analytic result of ROC curve showed that 360 pg/ml IL-18 could be seen as the critical value for diagnosis of the tubercular pleural effusion, whose sensitivity and specificity respectively was 89.2% and 93.5%. [ Conclusion] The concentration of IL-18 in pleural effusion can be taken as the referenee index in differential diagnose of the tubercular and the malignant pleural effusion. Key words IL-18 ; Sensitivity ;Speeifieity