良、恶性胸腔积液联检Survivin、HnRNP、TUM2-PK、CK19mRNA的价值探讨

Study on the Diagnostic Value of Combined Detection of Survivin,HnRNP,TUM2-PK and CK19mRNA in Pleural Effusion in Patients with Benign and Malignant Chest Disoders

目的:通过检测不同性质胸腔积液中Survivin、HnRNP、TUM2-PK、CK19mRNA的表达,探讨它们在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,抽取胸腔积液后分别进行Survivin、HnRNP、TUM2-PK、CK19mRNA检测。采用ELISA。结果:Survivin、HnRNP、TUM2-PK、CK19mRNA在恶性胸腔积液中的检测结果明显高于良性胸腔积液中结果,差异有显著意义(P<0.05)。结论:恶性胸腔积液中的Survivin、HnRNP、TUM2-PK、CK19mRNA的水平明显高于良性胸腔积液中的表达,差异有显著意义。联检Survivin+HnRNP、Survivin+TUM2-PK有较理想的敏感性和特异性。四项联检虽然敏感性有提高,但特异性下降明显,可能会影响实际应用。

Objective To study the differential diagnostic value of combined determination of pleural effusion contents of survivin,HnRNP,TUM2-PK and CK19mRNA in Patients with chest disorders.Methods Contents of survivin,heterogenous nuclear ribo-nucleo protein（HnRNA）,TUM2-pyruvate kinase K（TUM2-PK） and CK19mRNA in plearal effusion were determined with ELISA in 30 patients with lung cancer and 30 patients with tuberculosis.Results Contents of all the four tumor markers in pleural effusion of patients with lung cancer were significantly higher than those in patients with tuberculosis（P0.01 or P0.05）.For various forms of combinations,survivin＋HnRNP and survivin＋TUM2-PK were quite ideal（highest specificity with good sensitivity）.Combined detection of all four markers would result in a very high sensitivity（96.7%） at the cost of low specificity（only 56.8%）.Conclusion Combined detection of survivin with HnRNP or survivin with TUM2-PK contents in pleural effusion seems to be most ideal for differential diagnosis of malignancy from tuberculosis.However,Combined detectin of all four markers is inappropriate for clinical use due to its low specificity.