MMP-7、MMP-10、CEA水平检测在鉴别良恶性胸腔积液中的作用

Diagnostic value of MMP-7,MMP-10 and CEA in determination of benign or malignant pleural effusion

目的探讨MMP-7和MMP-10作为恶性胸腔积液肿瘤标志物的价值,以及评估MMP-7、MMP-10与癌胚抗原CEA联合诊断恶性肿瘤的价值。方法选取67名胸腔积液患者,其中35例为恶性胸腔积液,32例为良性胸腔积液。抽取胸腔积液后采用ELISA法测定MMP-7、MMP-10,化学发光法测定CEA的水平。结果 MMP-7和MMP-10在恶性胸腔积液组中的水平均显著高于良性组,差异有统计学意义。MMP-7在恶性胸腔积液诊断分界点为354ng/mL,敏感性为81.8%,特异性为73.9%。MMP-10在恶性胸腔积液诊断分界点为242ng/mL,敏感性为85.2%,特异性为64.1%。CEA在恶性胸腔积液诊断分界点为11.4ng/mL,敏感性为60.9%,特异性为83.6%。在恶性胸腔积液组中,MMP-7和MMP-10的表达具有显著相关性(P<0.01)。ROC曲线分析结果示,MMP-10的曲线下面积(0.806)显著大于MMP-7(0.771)和CEA(0.789)(P<0.01)。MMP-10和CEA的联合检测敏感度为94.6%。MMP-7和CEA的联合检测能够使特异度增加至95.7%。结论 MMP-7、MMP-10和CEA的联合检测可以得到比其单项检测更高的敏感度和特异度,因此其联合检测能够提高良恶性胸腔积液的鉴别诊断率。

Objective To investigate the diagnostic value of MMP-7 and MMP-10 as tumor markers in pleural effusion（PE） and evaluate the value of combining MMP-7,MMP-10 and carcinoembryonic antigen（CEA） assays as diagnostic aids for malignant cells.Methods Sixty-seven patients with pleural effusions were observed.Among them,35 cases suffered from malignant pleural and 32 suffered from benign one.The levels of MMP-7 and MMP-10 and CEA were measured using ELISA and chemistry luminescence technique.Results Values for MMP-7 and MMP-10 were significantly higher in malignant PE than those in benign PE（P〈0.01）.The cutoff of MMP-7 was 354ng/mL,the sensitivity of MMP-7 examination was 81.8%,and the specificity was 73.9%.The cutoff of MMP-10 was 242ng/mL,the sensitivity of MMP-10 examination was 85.2%,and the specificity was 64.1%.The cutoff of CEA was 11.4ng/mL,the sensitivity of CEA examination was 60.9%,and the specificity was 83.6%.Among all variables evaluated,logistic regression found that MMP-7 and MMP-10 were significantly correlated with the presence of ma- lignant disease（P〈0.01）.Analysis of receiver operating characteristics（ROC） curves showed that the area under the curve of MMP-10（0.806） was significantly larger than that of MMP-7（0.771） and CEA（0.789）（P〈0.01）.With parallel interpretation,the combination of MMP-10 and CEA achieved the higher sensitivity of 94.6%.The combination of MMP-7 and CEA in serial interpretation was able to boost the specificity to 95.7%.The combination of MMP-7,MMP-10 and CEA produced better sensitivity,specificity,than MMP-7 and MMP-10 alone.Conclusion MMP-7 and MMP-10 in PE may represent helpful adjuncts to conventional diagnostic tools in ruling out malignancy as a probable diagnosis.