结核性与癌性胸腔积液的实验室检测比较研究

Tuberculous and malignant pleural effusion Comparison of laboratory testing

目的比较研究实验室检测腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、癌胚抗原(CEA)、蛋白(TP)、葡萄糖(GLU)等多项指标对结核性与癌性胸腔积液的鉴别诊断价值。方法对151例明确诊断为结核性或癌性胸腔积液分别测定胸水ADA、LDH、CEA、TP、GLU和血清TP,并进行统计分析。结果结核性胸腔积液中ADA、LDH、TP含量都明显高于癌性胸腔积液,其中胸水ADA以28U/L作为诊断结核性胸水的临界值则其敏感性和特异性均极高,结核性胸水中GLU含量则低于癌性胸水,癌性胸水CEA的阳性率高达76.0%,而结核性胸水CEA均阴性。结论联合检测胸水ADA、LDH、CEA、TP和GLU可以作为结核性与癌性胸腔积液的诊断和鉴别诊断依据,其中ADA>28U/L可以考虑作为结核性胸腔积液的单独诊断依据。

Objective To compare the laboratory study of adenosine deaminase（ADA）,lactate dehydrogenase（LDH）,carcinoembryonic antigens（CEA）,protein（TP）,glucose（GLU）and many other indicators of tuberculosis and cancer pleural effusion diagnosis.Methods 151 patients diagnosed as tuberculous or malignant pleural effusions were measured in pleural ADA,LDH,CEA,TP,GLU,and serum TP,and statistical analysis.Results tuberculous pleural effusion ADA,LDH,TP concentrations are significantly higher than that of malignant pleural effusion,in which pleural effusion ADA28U/L diagnosis of tuberculous pleural effusion as the critical value of high sensitivity and specificity,tuberculosis pleural effusion GLU content was lower than the malignant pleural effusion,malignant pleural effusion CEA positive rate of 76.0%,while tuberculous pleural effusion were negative for CEA.Conclusion The detection of pleural fluid ADA,LDH,CEA,TP and GLU as tuberculosis and malignant pleural effusion based on the differential diagnosis,including ADA28U/L can be considered as a separate tuberculous pleural effusion diagnosis.