肺癌和肺结核相关生化指标变化及鉴别诊断

Changes of biochemical index co-related with lung cancer and tuberculosis and differential diagnosis

目的:分析肺癌和肺结核患者外周血和胸腔积液中瘦素(LEP)、肿瘤坏死因子-α(TNF-α)、癌胚抗原(CEA)、白介素-6(IL-6)、IL-8、C反应蛋白(CRP)和D-二聚体(D-Dimer)的变化,并探讨其在肺癌和肺结核鉴别诊断中的价值。方法:以2013-07~2015-12本院收治的肺癌患者58例、肺结核患者54例为研究对象,测定各组外周血和部分患者胸腔积液中LEP、TNF-α、CEA、IL-6、IL-8、CRP和D-Dimer水平。结果:肺癌组外周血和胸腔积液LEP、TNF-α、CEA和DDimer均高于肺结核组,IL-6、IL-8均低于肺结核组,差异均有统计学意义;肺癌组外周血CRP高于肺结核组,胸腔积液CRP低于肺结核组,但差异均无统计学意义。结论:肺癌患者LEP、TNF-α、CEA和D-Dimer均高于肺结核患者,通过联合检测可提高其诊断灵敏性,有助于肺癌及肺结核的鉴别诊断。

Objective:To analyze the changes of leptin(LEP),tumor necrosis factor-α(TNF-α),carcinoembryonic antigen(CEA),interleukin-6(IL-6),IL-8,C-reactive protein(CRP)and D-dimer(D-Dimer)in peripheral blood and pleural effusion of patients with lung cancer and tuberculosis,and to explore their values in the differential diagnosis between lung cancer and tuberculosis.Methods:Fifty-eight patients with lung cancer and 54 patients with pulmonanry tuberculosis admitted in our hospital from July of 2013 to December of 2015 were selected and divided into lung cancer group and tuberculosis group.LEP,TNF-α,CEA,IL-6,IL-8,CRP and D-Dimer were detected in peripheral blood and pleural effusion.Results:LEP,TNF-α,CEA and D-Dimer in peripheral blood and pleural effusion were higher in lung cancer group than in tuberculosis group,and the differences were statistically significant.IL-6,IL-8in peripheral blood and pleural effusion were lower in lung cancer group than in tuberculosis group,the differences were statistically significant.CRP in peripheral blood was higher in lung cancer group than in tuberculosis group while CRP in pleural effusion was lower in lung cancer group than in tuberculosis group,but the differences were not statistically significant.Conclusion:Combined detection of LEP,TNF-α,CEA and D-Dimer are beneficial in the differential diagnosis of lung cancer and pulmonary tuberculosis.