在良恶性胸腹水诊断中MMP-3和LDH的临床价值

The clinical value of MMP-3 and LDH in the diagnosis of benign and malignant pleural effusion and ascites

目的探讨胸腹水中基质金属蛋白酶-3(MMP-3)、乳酸脱氢酶(LDH)在良恶性胸腹水判断中的应用价值。方法回顾性分析阳谷县人民医院2018年2月-2019年3月收治的120例住院患者胸腹水标本,其中胸水61例,腹水59例,依照良恶性情况分为良性胸水组33例、良性腹水组31例、恶性胸水组28例和恶性腹水组28例,比较患者胸腹水MMP-3和LDH水平,通过受试者工作特性(ROC)曲线评价MMP-3和LDH在鉴别良恶性胸腹水中的应用价值。结果良性胸水组MMP-3、LDH水平均低于恶性胸水组;良性腹水组MMP-3、LDH水平均低于恶性腹水组,差异均有统计学意义(P<0.05)。胸水中MMP-3、LDH联合检测诊断良恶性ROC曲线下的AUC高于MMP-3、LDH单独检测诊断曲线下的AUC,差异均有统计学意义(P<0.05);腹水中MMP-3、LDH联合检测诊断良恶性ROC曲线下的AUC高于MMP-3、LDH单独检测诊断曲线下的AUC,差异均有统计学意义(P<0.05);pearson相关性分析显示,胸腹水中MMP-3、LDH均呈正相关。结论恶性胸腹水中MMP-3、LDH表达水平高于良性胸腹水,MMP-3、LDH联合检测在诊断良恶性胸腹水中具有较高的效能,值得临床推广应用。

Objective To investigate the application value of matrix metalloproteinase-3(MMP-3)and lactate dehydrogenase(LDH) in pleural effusion and ascites in judging benign and malignant pleural effusion and ascites. Methods One hundred and twenty patients with pleural effusion and ascites in Yanggu County People’s Hospital from February 2018 to March 2019 were retrospectively analyzed,including 61 cases of pleural effusion and 59 cases of ascites. According to the benign and malignant conditions,they were divided into benign pleural effusion group with 33 cases,benign ascites group with31 cases,malignant pleural effusion group with 28 cases and malignant ascites group with 28 cases. The levels of MMP-3 and LDH in pleural effusion and ascites of patients were compared,and the receiver operating characteristic(ROC)curve was used to evaluate the application value of MMP-3 and LDH in differentiating benign and malignant pleural effusion and ascites. Results The levels of MMP-3 and LDH in benign pleural effusion group were lower than those in malignant pleural effusion group;the levels of MMP-3 and LDH in benign ascites group were lower than those in malignant ascites group,and the differences were statistically significant(P <0.05). The AUC under the ROC curve of MMP-3 and LDH combined detection diagnosis of benign and malignant in pleural effusion was higher than that of MMP-3 and LDH alone detection in diagnosis curve,and the differences were statistically significant(P<0.05). The AUC under the ROC curve of MMP-3 and LDH combined detection in diagnosis of benign and malignant in ascites was higher than that of MMP-3 and LDH alone detection in diagnosis curve,and the differences were statistically significant(P <0.05). Pearson correlation analysis showed that MMP-3 and LDH were positively correlated in pleural effusion and ascites. Conclusion The expression levels of MMP-3 and LDH in malignant pleural effusion and ascites were higherer than those in benign pleural and ascites. The combined detection of MMP-3 and LDH had higher efficiency in diagnosis of benign and malignant pleural effusion and ascites,which was worthy of clinical application.