肺结核与肺癌患者胸腔积液蛋白电泳及腺苷脱氨酶联合检测评估

The significance of joint assessment of protein electrophoresis and examination of adenosine deaminase in pleural effusion for differential diagnosis of patients with pulmonary tuberculosis or lung cancer

目的评估胸腔积液中蛋白电泳和腺苷脱氨酶(ADA)联合检测在对肺结核及肺肿瘤患者临床鉴别诊断中的意义。方法分别对27例肺结核患者和32例肺肿瘤患者的胸腔积液标本进行蛋白电泳及ADA检测。结果在蛋白电泳的检测中结核组白蛋白、α1、α2、β、γ球蛋白所占比率分别为55.3%、3.7%、8.4%、10.7%和22.0%,肿瘤组为58.1%、3.6%、8.5%、10.7%、19.1%,两组结果无统计学差异(P>0.05);结核组ADA值(53.6±25.3IU/L)高于肿瘤组(20.1±30.1IU/L),两者有统计学差异(P<0.05)。结论胸腔积液ADA检测对于肺结核与肺肿瘤的鉴别诊断具有一定的临床意义。胸腔积液蛋白电泳对于鉴别结核性与肿瘤性胸腔积液的意义未体现。

Objective To evaluate the clinical significance of protein electrophoresis and determination of adenosine deaminase in pleural fluid for differential diagnosis of hydrothorax in patients with pulmonary tuberculosis or lung cancer.Methods Fluid samples of hydrothorax in 27 patients with pulmonary tuberculosis and 32 patients with lung cancer were simultaneously examined for protein electrophoresis and adenosine deaminase.Results The figures of Alb,α1,α2,β and γ globulins in pleural fluid of patients with tuberculosis were 55.3%,3.7%,8.4%,10.7% and 22.0% respectively,and these figures in patients with lung cancer were 58.1%,3.6%,8.5%,10.7% and 19.1% respectively.There was no statistically significant difference between these two groups.（P0.05） The detection rate of adenosine deaminase in patients with tuberculosis was （53.6±25.3 IU/L） and that in patients with lung cancer was （20.1±30.1 IU/L）,and there was statistically significant difference between these two groups （P0.05）.Conclusion The difference in figures of adenosine deaminase and protein electrophoresis in pleural fluid between patients with tuberculosis and lung cancer is statistically significant.Some authors suggest that protein electrophoresis may be helpful in differential diagnosis of tuberculosis and lung cancer,but it can not be proved in this study.