血清肿瘤坏死因子-α检测对结核性和癌性胸腔积液鉴别诊断价值的研究

The Diagnostic Value of Detecting TNF-α Concentrations of Serum in Tuberculous and Malignant Pleural Effusion

目的 评价肿瘤坏死因子 -α(TNF -α)对结核性胸腔积液 (以下简称结核组 )及非小细胞肺癌引起的癌性胸腔积液鉴别诊断的价值。方法 采用双抗体夹心免疫酶标法 (ELISA)检测 2 5例结核性胸腔积液、4 7例癌性胸腔积液 (其中肺腺癌 2 6例、肺鳞癌 2 1例 )患者血清及 2 0例正常人血清中TNF -α水平。结果 肺腺癌组(12 1 75± 6 0 82 )和肺鳞癌组 (16 7 5 4± 6 9 76 )患者血清TNF -α水平 (6 2 6 4± 18 0 0 )明显高于结核组 (P <0 0 1) ,三组均高于正常对照组 (43 79± 2 3 82 ) ;选择结核组血清TNF -α水平的P75数值作为判断界限 ,血清TNF -α水平作为鉴别这两种不同性质胸腔积液的灵敏度、特异性、准确度分别为 77 70 %、72 0 0 %、90 19%。结论 血清TNF -α检测对鉴别结核性及非小细胞肺癌引起的癌性胸腔积液有较高的参考价值 。

Objcetive To evaluate tumor necrosis factor-alpha(TNF-α) in differentiating diagnosis of tuberculous and non-small cell lung cancer with cytology-positive pleural effusion.Methods We measured TNF-α of serum in 25 patients with tuberculous effusion,26 cases of lung adenocarcinoma,21 cases of lung squamous cell carcinoma with pleural effusion and controls by enzyme-linked immunosorbant assays.Results Serum TNF-α levels in patients with tuberculous pleural effusion were lower than that in patienrts with lung adenocarcinoma and lung squamous cell carcinoma(P<0 01,),serum TNF-α levels either in tuberculous patients or in cancer patients were high,as compared with that in controls.The sensitivity,specificity and accuracy of serum TNF-α levels in the diagnosis of tuberculous and carcinoma pleurisy were 77 00%,72 00%,90 19% respectively.Conclusion Our results indicates that the measurement of TNF-α in serum is a useful diagnostic tool for differentiating malignant pleurisy from tuberculous pleurisy.