| Objective:Pleural effusion is a common disease of respiratory system disease,which caused by fluid within the pleural cavity formation and absorption out of balance,namely the quantity produced by the plural is greater than absorbed.At the same time with the increasing of cancer disease incidence rate,the number of patients with malignant pleural effusion also subsequently heighten.The pleural effusion caused by malignant tumor is difficult in treatment and the prognosis is also poor,usually it progresses quickly.So if we can diagnose the disease timely and clearly,it will be a great significance in the diagnosis and treatment of malignant pleural effusion disease.This study will detecte the content of adenosine deaminase(ADA),lactate dehydrogenase(LDH)enzyme,C-reactive protein(CRP),carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)in benign pleural effusion(mainly for tuberculous pleural effusion)and malignant pleural effusion to discuss their value in the differential diagnosis of benign and malignant pleural effusion disease.Methods:In the period of January 2015 to January 2016,we collected 90 patients diagnosed with pleurl effusion in Hebei Medical University Second Hospital and Hebei Province Thoracic Hospital,and then tested the pleural effusion of 90 patients when they were hospitalized.Depending on the basis of the final diagnosis,80 of them divided into two groups: malignant pleural effusion group(38 cases)and benign pleural effusion group(42 cases)were able to be under study.ADA and LDH were tested by Beckman automatic analyzer AU5821;CRP was tested by Beckman coulter immage 800;CA125 was tested by Beckman automatic analyzerDXI800;CEA was tested by Abott ACCC 4008-898-4008isR51809.All the values of ADA,LDH,CRP,CEA and CA125 in differentiating benign and malignant pleural effusion were researched by retrospective study,and the results were analyzed and evaluated by the method of receiver-operating characteristic curve(ROC curve).Results:1 In the group of benign pleural effusion,there was 42 patients aged from 12to79(32.74 ±15.82);while there was 38 patients with malignant pleural effusion,aged from19 to83(63.42±13.91).The age of benign pleural group age was younger than that of malignant pleural effusion group,which was statistically significant(p < 0.01).2 The levels of ADA,CRP,CEA,CA125 and LDH of benign pleural effusion group respectively(43.95±16.63)U/L,(33.17±8.81)mg/L,(1.52±0.65)ng/mL,(522.75±263.45)u/mL and(485.67±210.69)U/L,the malignant pleural effusion group respectively(16.93±8.79)U/L,(13.59±7.05)mg/L,(243.37± 193.73)ng/mL,(1079.32±480.66)u/mL and(451.55±220.81)U/L.The levels of ADA and CRP of benign pleural effusion were significantly higher than those of malignant pleural effusion(P<0.01).The levels of CEA and CA125 of malignant pleural effusion were obviously higher than those of benign pleural effusion with statistically significant difference(P<0.01).The difference on the LDH level between benign and malignant pleural effusion showed no significant difference(P>0.05).3 According to the ROC curve obtained ADA ? 32.50U/L,CRP ?14.35mg/L as the critical value,the sensitivity,specificity and area under the ROC curve(AUC)of ADA and CRP in the diagnosis of benign pleural effusion respectively 76.2%,94.7%,0.914;95.2%,92.1%,0.924.According to the ROC curve obtained CEA?2.3ng/mL,CA125?505.75U/L as the critical value,The sensitivity,specificity and area under the ROC curve(AUC)of CEA and CA125 inthe diagnosis of malignant pleural effusion respectively92.1%,95.2%,0.963;89.5%,71.4%,0.879,when combining CEA with CA125 to diagnose malignant pleural effusion those will change into 89.5%,95.2%.Conclusions:1 The difference of age in both groups was statistically significant,youth is easy to get benign pleural effusion,while the elderly still fall ill of malignant pleural effusion.2 Both ADA and CRP have important significance in the diagnosis of benign pleural effusion,especially CRP which sensitivity and specificity are better.3 The CEA and CA125 in the differential diagnosis of malignant pleural effusion have important meaning,the significance of CEA is particularly important,the joint detection can improve the detection specificity of CA125 alone in malignant pleural effusion.4 The LDH in benign pleural effusion and malignant pleural effusion was no statistically significant difference(P>0.05),so it is not recommended for the differential diagnosis of benign and malignant pleural effusion. |
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