apoE在鉴别肺部疾病胸水性质的初步研究

Preliminary study of apoE in identifying pleural fluid from lung diseases

目的探讨apoE在鉴别肺疾病良恶性胸水的价值。方法收集2011年4月-2012年2月温州医学院附属第一医院肺部疾病患者的恶性胸水标本160例,良性胸水标本40例。采用ELISA方法检测apoE蛋白水平,化学发光法检测肿瘤标志物,结合临床资料对各组进行统计学分析。结果 MPE的apoE水平明显高于良性胸水;肺腺癌胸水apoE水平明显高于肺鳞癌和大细胞癌胸水。ROC曲线表明apoE在Cutoff值为105 ng/ml时,诊断MPE的敏感性和特异性分别为87.5%和85.3%,曲线下面积(AUC)为0.748。对于诊断肺腺癌MPE,apoE的敏感性和特异性分别为70.8%和83.3%,AUC为0.856在所有标志物中最高。结论非小细胞肺癌胸水apoE水平明显升高;胸水apoE可能是一个用于诊断非小细胞肺癌MPE的潜在肿瘤标志物。

Objective To investigate the value of apoE in the identification of lung disease in benign and malignant pleural effu- sion. Methods We collected 160 cases of malignant pleural effusion specimens, and 40 cases benign pleural effusion speci- mens in the First Affiliated Hospital of Wenshou Medical College From April 2011 to February 2012. The apoE protein level was analyzed by the ELISA and tumor markers were detected by chemiluminescence method, the clinical data of each group were collected for statistically analysis. Results The apeE levels of MPE were significantly higher than that of benign pleural effu- sions. Of which the apoE level of pleural effusion in adenocarcinoma was higher than that in squamous cell carcinoma and large cell carcinoma. The ROC curve showed that the sensitivity and specificity of apoE for the diagnosis of MPE was 87.5% and 85.3% respectively, at the cutoff 105 ng/ml and gave area under the curve （AUC） 0. 748. For the diagnosis of adenocarcino- ma MPE, apoE achieved the sensitivity and specificity 70.8% and 83.30% respectively and the AUC was the highest among all the markers. Conclusion The apoE levels are significantly increased in the pleural effusion of NSCLC. Elevated pleural effu- sion apoE can be a potential tumor marker for the diagnosis of MPE in NSCLC.