血清和胸水中MCP-1、MSP、LEP在肺癌及肺结核鉴别中的应用价值

The application value of MCP-1,MSP,LEP in the identification of lung cancer and tuberculosis

目的探讨单核细胞趋化蛋白-1(MCP-1)、巨噬细胞刺激蛋白(MSP)、血清瘦素(LEP)在鉴别肺癌及肺结核中的价值及意义。方法 2015年1—12月江苏省泰州市人民医院感染科选取经痰涂片确诊为肺结核患者50例(肺结核组)及经病理组织学确诊为肺癌患者50例(肺癌组),另选取同期健康体检者45例为健康对照组。应用ELISA法测定血清及胸水中MCP-1、MSP、LEP水平。应用受试者工作特征曲线(ROC)确定MCP-1、MSP、LEP在肺癌及肺结核鉴别中的应用价值。结果与健康对照组比较,肺结核组、肺癌组血清中MCP-1、MSP、LEP均升高(P<0.05);与肺结核组比较,肺癌组血清LEP升高、MCP-1降低(P<0.05),而MSP无显著变化(P>0.05)。肺癌组胸水MSP、LEP高于肺结核组(P<0.05),而MCP-1低于肺结核组(P<0.05)。经ROC分析显示,诊断肺癌时,胸水中MSP在470 pg/ml时灵敏度最高(91.1%),MSP在1 200pg/ml时,特异度最高(94.2%);诊断肺结核时,胸水中MCP-1在500 Pg/ml时灵敏度最高(94.5%),MCP-1在1 100 pg/ml时,特异度最高(93.2%)。结论血清及胸水中MCP-1、MSP、LEP联合检测能有效鉴别肺结核与肺癌,灵敏度高,值得临床应用推广。

Objective To investigate the application value of monocyte chemoattractant protein-1 （ MCP-1 ） , macro-phage stimulating protein （ MSP） , serum leptin （ LEP） in the identification of lung cancer and tuberculosis .Methods 50 ca-ses of sputum smear diagnosed as tuberculosis and 50 cases of histologically diagnosed as lung cancer , 45 cases of healthy peo-ple were selected as control group from January 2015 to December 2015.The levels of MCP-1, MSP, LEP of three groups were measured by ELISA method .The value of MCP-1, MSP, LEP in identification of lung cancer and tuberculosis were de-termined with Receiver Operating Characteristic （ROC）.Results Blood samples were tested： The levels of MCP-1, MSP, LEP of lung cancer and tuberculosis were higher than control group （ P 〈0.05）.Compared with tuberculosis group, the level of LEP of lung cancer group was higher （ P 〈0.05）, the level of MCP-1 was lower （ P 〈0.05）, while MSP had no signifi-cant changes （ P 〉0.05）.Detection of pleural effusion：the levels of MSP, LEP of lung cancer group were higher than tuber-culosis group （ P 〈0.05）, whereas MCP-1 was lower than tuberculosis group （ P 〈0.05）.ROC analysis showed that in the diagnosis of lung cancer , when MSP was 470 pg/ml, the sensitivity （91.1%） of MSP in pleural effusion was the highest , and the specificity was highest （94.2%） at 1 200 pg/ml.In diagnosis of pulmonary tuberculosis , when MCP-1 was 500 pg /ml, the sensitivity （94.5%） was the highest, and the specificity （93.2%） was the highest at 1 100 pg /ml.Conclusion Com-bined detection of MCP-1, MSP and LEP in the pleural fluid can effectively discriminate tuberculosis and lung cancer , and the sensitivity is high , so it is worthy of clinical application and promotion .