白细胞介素-27对结核性胸腔积液的诊断价值
Diagnostic value of interleukin-27 in tuberculous pleural effusion
目的 探讨白细胞介素(IL)-27对结核性胸腔积液的诊断价值.方法 对2013年3月至2014年2月山东省立医院呼吸科收治的76例胸腔积液患者按照胸腔积液性质分为:(1)结核组:结核性胸腔积液患者40例,其中男22例,女18例;年龄19~73岁;(2)恶性组:恶性胸腔积液患者36例,其中男20例,女16例;年龄33 ~78岁;包括肺癌28例,淋巴瘤3例,食管癌1例,原发部位不确定的肿瘤4例.采用酶联免疫吸附法检测两组患者胸腔积液和血清中的IL-27浓度并进行统计学分析,应用受试者工作特征(ROC)曲线判断其对结核性胸腔积液的诊断价值.结果 结核组胸腔积液中IL-27的浓度为(1 402±321) ng/L,显著高于恶性组的(556±133) ng/L,且显著高于本组血清中的(499±88) ng/L(均P<0.05).应用ROC曲线确定IL-27诊断结核性胸腔积液的最佳临界值为838 ng/L,敏感度为95.0%,特异度为97.2%,准确度为96.1%.结论 IL-27对结核性胸腔积液的诊断有重要参考价值,值得临床推广和应用.
更多Objective To explore the diagnostic value of interleukin-27 (IL-27) in tuberculous pleural effusion.Methods A total of 76 patients of pleural effusion treated at Shandong Provincial Hospital from March 2013 to February 2014 in accordance with the natures of effusion fluid were divided into:(1) Tuberculosis group of tuberculous pleural effusion (n =40),including 22 males and 18 females; aged 19 to 73 years; (2) Malignant group of malignant pleural effusion (n =36),including 20 males and 16 females; aged 33 to 78 years old; including lung cancer (n =28),lymphoma (n =3),esophageal (n =1) and uncertain primary tumor site (n =4).The effusion and serum levels of IL-27 were detected by enzymelinked immunosorbent assay (ELISA) and the results analyzed.And the curve of receiver operating characteristic (ROC) was employed to determine the diagnostic value of IL-27 in tuberculous pleural effusion.Results The level of IL-27 was (1 402 ± 321) ng/L in tuberculous pleural effusion and it was significantly higher than those in malignant pleural effusion (556 ± 133) ng/L and sera (499 ± 88) ng/L (both P < 0.05).According to the ROC curve,the cut-off value of IL-27 was 838 ng/L in diagnosing tuberculous pleural effusion.And the rates of diagnostic sensitivity,specificity and accuracy of IL-27 were 95.0%,97.2% and 96.1% respectively.Conclusions Detection of pleural effusion IL-27 concentration is of great importance in the diagnosis of tuberculous pleural effusion.And it is worthy of wider clinical promotion.
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