PCT、TNF-a、IL-6、IL-8在胸腔积液诊断中的应用价值

Application value of PCT,TNF-α,IL-6 and IL-8 in the diagnosis of pleural effusion

目的探讨降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)在胸腔积液及血清中的表达及在胸腔积液中的诊断价值。方法肺结核并发胸腔积液患者56例,肺癌并发胸腔积液患者58例;用酶联免疫吸附试验(ELISA)法测定PCT、TNF-a、IL-6、IL-8在胸腔积液及血清中的水平。60例健康人的外周血作为对照。结果肺结核组患者血清TNF-a、IL-6、IL-8的水平均高于肺癌组(P<0.05),两组患者血清PCT水平无统计学差异(P>0.05);肺结核组胸腔积液TNF-a、IL-6、IL-8水平均高于肺癌组(P<0.05),两组患者胸腔积液PCT水平无统计学差异(P>0.05);同时收集胸水和血清标本的肺结核组和肺癌组114例患者的胸腔积液TNF-a、IL-6、IL-8水平均高于血清水平(P<0.05),但胸腔积液与血清TNF-a、IL-6、IL-8均无明显相关性,而两者PCT水平存在正相关性(r=0.742,P<0.01)。血清及胸腔积液中3种相关因子联合检测灵敏性、特异性与各单项相比差异有统计学意义(P<0.05)。结论通过检测胸腔积液及血清中TNF-α、IL-6、IL-8的表达水平将有助于鉴别诊断肺癌及肺结核患者,但PCT在胸腔积液的鉴别诊断中无重要的参考价值。

Objective To investigate the application value of PCT, TNF-a, IL-6 and IL-8 in the diagnosis of pleural effusion. Methods The level of PCT, TNF-a, IL-6 and IL-8 in serum and pleural effusion of 56 patients with pulmonary tuberculosis pleural effusion and 58 patients with lung cancer pleural effusion were measured with ELISA. There were 60 cases of healthy individual of peripheral blood in comparison. Results The levels of TNF-a, IL-6, IL-8 in serum of Tuberculosis group were higher than those in the lung cancer group （P〈0. 05）. The level of PCT in pleural effusion of the two groups had no statistical difference （P〉0. 05）. The levels of TNF-a, IL-6 and IL-8 in the pleural effusion of tuberculosis group were higher than those in the lung cancer group （P〈0. 05）. The level of PCT in pleural effusion of the two groups had no statistical difference （P〉0. 05）. While collecting the pleural ef-fusion and serum specimens of the tuberculosis and lung cancer groups, the levels of TNF-a, IL-6 and IL-8 in pleural effusion were higher than in serum （P〈0. 05）, but they had no obvious correlation. The level of PCT in pleural effu-sion revealed notably positive relation with those in serum （r=0. 742, P〈0. 01）. The factor sensitivity, specificity of serum and pleural effusion were higher than those in single （P〈0. 05）. Conclusion The detection of pleural ef-fusion and serum TNF-a, IL-6 and IL-8 levels will help the differential diagnosis of lung cancer and tuberculosis pa-tients, but the PCT in the differential diagnosis of pleural effusion has not any important reference value.