白细胞介素27、腺苷脱氨酶和γ-干扰素对结核性胸膜炎的诊断效能分析

Analysis on diagnostic efficiency of interleukin 27,adenosine deaminase andγ-interferon in tuberculous pleurisy

目的探讨白细胞介素27(IL-27)、腺苷脱氨酶(ADA)和γ-干扰素(IFN-γ)对结核性胸膜炎(TBP)的诊断效能。方法收集2022年5月至2023年5月于该院就诊的315例患者胸腔积液标本,其中165例确诊为TBP纳入TBP组,其他150例纳入对照组(以恶性胸腔积液为主)。检测两组胸腔积液中IL-27、ADA和IFN-γ水平,绘制受试者工作特征(ROC)曲线,并通过ROC曲线下面积(AUC)对各指标单独和联合诊断的灵敏度和特异度进行评估。结果TBP组IL-27、ADA和IFN-γ水平均高于对照组(P<0.05);单一指标诊断TBP的AUC值均超过0.85,其中ADA诊断TBP的AUC值最大(0.92),最佳截断值为22.48 U/L时,诊断灵敏度和特异度分别为80.61%和93.33%;联合诊断时IL-27和IFN-γ指标联合诊断效能最佳,AUC值为0.94,灵敏度和特异度分别为89.70%和93.33%。结论IL-27、ADA和IFN-γ单一指标对TBP均具有较高的诊断效能,但IL-27和IFN-γ联合诊断更具有优势。

Objective To investigate the diagnostic efficiency of interleukin-27(IL-27),adenosine deaminase(ADA)and interferon-γ(IFN-γ)in tuberculous pleurisy(TBP).Methods The pleural effusion samples in 315 cases visiting in this hospital from May 2022 to May 2023 were collected.Among them,165 cases diagnosed as TBP were included in the TBP group,and the other 150 samples were included in the control group(mainly malignant pleural effusion).The levels of IL-27,ADA and IFN-γin pleural effusion were detected.The receiver operating characteristic(ROC)curve was drawn,and the sensitivity and specificity of each indicator alone and combined diagnosis were evaluated by the area under the ROC curve(AUC).Results The levels of IL-27,ADA and IFN-γin the TBP group were higher than those in the control group(P<0.05).The AUC value of single indicator in diagnosing TBP all exceeded 0.85,in which AUC of ADA for diagnosing TBP was maximal(0.92),when its optimal cutoff value was 22.48 U/L,the sensitivity and specificity of diagnosis were 80.61%and 93.33%,respectively,when the combined diagnosis,the diagnostic efficiency of IL-27 and IFN-γcombination was optimal,the AUC value was 0.94,the sensitivity and specificity were 89.70%and 93.33%respectively.Conclusion The single indicator of IL-27,ADA and IFN-γhas the higher diagnostic efficiency for TBP,but the combination diagnosis of IL-27 and IFN-γhas more advantages.