腹水IL-27、IFN-γ及ADA对结核性腹水与癌性腹水和漏出性腹水的鉴别价值

The value of IL-27,IFN-γand ADA in differential diagnosis of tuberculous peritoneal effusion from cancerous peritoneal effusion or leaky peritoneal effusion

目的探讨腹水白细胞介素-27(IL-27)、γ干扰素(IFN-γ)及腺苷脱氨酶(ADA)对结核性腹水(TPE)与癌性腹水和漏出性腹水的鉴别价值。方法选取2018年3月至2020年5月在该院住院治疗的腹水患者107例,根据病因分为TPE组(n=42)、癌性腹水组(n=31)及漏出性腹水组(n=34)。检测所有患者腹水及血清中的IL-27、IFN-γ及ADA水平,同时采用ROC曲线分析以上3个指标对TPE的鉴别价值。结果TPE组、癌性腹水组和漏出性腹水组血清中IL-27、IFN-γ和ADA水平差异均无统计学意义(P>0.05)。与癌性腹水组和漏出性腹水组相比,TPE组腹水中的IL-27、IFN-γ和ADA水平均明显提高(P<0.05)。腹水中IL-27、IFN-γ和ADA联合检测的曲线下面积(AUC)明显大于IL-27、IFN-γ和ADA单项检测的AUC(P<0.05),3项指标联合检测的灵敏度和特异度分别为95.24%、90.77%,且阴性似然比为0.05。结论与癌性腹水和漏出性腹水相比,腹水中IL-27、IFN-γ及ADA水平在TPE显著增加,且三者联合检测对TPE具有较好的鉴别价值,有广泛的应用前景。

Objective To investigate the identification value of interleukin-27(IL-27),interferon-γ(IFN-γ)and adenosine deaminase(ADA)in tuberculous peritoneal effusion(TPE),cancerous peritoneal effusion and leaky peritoneal effusion.Methods One hundred and seven inpatients with peritoneal effusion admitted to this hospital from March 2018 to May 2020 were selected and divided into the TPE group(n=42),cancer peritoneal effusion group(n=31)and transudative peritoneal effusion group(n=34)according to the etiology.The levels of IL-27,IFN-γand ADA in effusion and serum were detected in all patients,meanwhile the receiver operating characteristic(ROC)curve was adopted to analyze the differentiating value of the above three indicators for TPE.Results There was no statistically significant difference in serum IL-27,IFN-γand ADA levels among the TPE group,carcinoma peritoneal effusion group and transudative peritoneal effusion group(P>0.05).Compared to the carcinoma peritoneal effusion group and the transudative peritoneal effusion group,the levels of IL-27,IFN-γand ADA in the peritoneal effusion of the TPE group were significantly increased(P<0.05).The area under curve(AUC)of IL-27,IFN-γand ADA combinination was significantly greater than that of single detection of IL-27,IFN-γand ADA(P<0.05),the sensitivity and specificity of 3-item combination detection were 95.24%and 90.77%,respectively,moreover,the negative likelihood ratio was 0.05.Conclusion Compared with the cancerous peritoneal effusion and transudative peritoneal effusion,the IL-27,IFN-γand ADA levels in TPE are significantly increased,moreover the 3-item combination detection has good differentiation value for TPE and broad application prospect.