血管内皮生长因子、基质金属蛋白酶-2对良恶性胸腔积液的诊断价值

The diagnostic value of vascular endothelial growth factor and matrix metalloproteinase-2 in malignant/benign pleural effusion

目的探讨胸腔积液中血管内皮生长因子(VEGF)和基质金属蛋白酶-2(MMP-2)水平对恶性胸腔积液及结核性胸腔积液(良性)的鉴别诊断价值。方法采用ELISA法,检测40例恶性胸腔积液、40例结核性胸腔积液病人胸腔积液中VEGF和MMP-2表达水平,并进行比较。结果恶性胸腔积液组VEGF和MMP-2水平均明显高于结核性胸腔积液组,差异有显著性(P<0.01)。良恶性胸腔积液中VEGF和MMP-2表达水平呈正相关。VEGF和MMP-2联合检测可提高敏感性和特异性,分别为:86.5%、95.6%。若VEGF、MMP-2和CEA联合检测其敏感性和特异性分别为:92.1%、100%。结论联合检测胸腔积液VEGF和MMP-2对鉴别结核性和恶性胸腔积液具有重要的临床价值。

Objective To investigate the value of vascular endothelial growth factor（VEGF） and matrix metalloproteinase-2（MMP-2） in differentiating tuberculous from malignant pleural effusion.Methods Using ELISA,the levels of VEGF and MMP-2 in pleural effusion in 40 patients with tuberculous pleural effusion and 40 with malignant pleural effusion were detected and compared.Results The VEGF and MMP-2 levels in malignant pleural fluid were markedly higher than those in tuberculous pleural fluid,with a significant difference between them（P0.01）.The expression of VEGF was correlated significantly positive with the expression MMP-2 in pleural fluid（r=0.832,P0.01）.The sensitivity and specificity of combined detection of VEGF and MMP-2 increased to 86.5% and 95.6%,respectively.Moreover,for VEGF,MMP-2 and CEA,the sensitivity and specificity combined detection increased to 92.1% and 100%,respectively.Conclusion Combined detection of VEGF and MMP-2 in pleural effusion is of great clinical significance in differentiating tuberculous from malignant pleural effusion.