摘要
目的 探讨肺结核、肺癌患者的胸腔积液和外周血中趋化因子单核细胞趋化蛋白-1(MCP-1)、巨噬细胞刺激蛋白(MSP)和癌胚抗原(CEA)的表达及其临床意义。方法 选取2009年12月至2011年12月在浙江省衢州市人民医院住院的34例肺结核患者和45例经病理学确诊的肺癌患者,另选30名健康献血成年人作为健康对照组。血清和胸水MCP-1和MSP检测采用酶联免疫吸附试验(ELISA),CEA检测采用化学发光法。通过受试者工作特征曲线确定MCP-1、MSP和CEA诊断肺结核或肺癌的临界值。结果 肺结核组和肺癌组患者血清中MCP-1、MSP和CEA水平均不同程度高于健康对照组。血清样本检测发现,肺结核组患者MCP-1水平高于肺癌组(t=2.69,P＜0.05),CEA水平低于肺癌组(t=0.89,P＞0.05),MSP水平与肺癌组比较差异无统计学意义(t=2.89,P＜0.05);胸腔积液样本检测发现,肺结核组患者的MCP-1水平高于肺癌组(=3.54,P＜0.05),而MSP和CEA水平则低于肺癌组(=3.47和3.48,P＜0.05)。诊断肺结核时,血清MCP-1水平在240 pg/mL时的特异度最高,为95.6％;诊断肺癌时,胸水MSP水平在1100 pg/mL时的特异度最高,为94.1％。结论 血清和胸水中MCP-1、MSP以及CEA联合检测可用于鉴别肺癌与肺结核。
Objective To investigate the detection of monocyte chemotactic protein 1 (MCP-1),macrophage stimulating protein (MSP) and carcinoembryonic antigen (CEA) in differential diagnosis of pulmonary tuberculosis and lung cancer.Methods Thirty four patients with pulmonary tuberculosis,45 patients with pathologically confirmed lung cancer admitted in Quzhou People' s Hospital during December 2009 and December 2011,and 30 healthy controls were enrolled in the study.MCP-1 and MSP in serum and pleural effusion were determined by enzyme linked immunosorbent assay (ELISA),and CEA was detected by chemiluminescence method.Receiver operating characteristic method was used to determine the cut-off values of MCP-1,MSP and CEA in diagnosis of pulmonary tuberculosis or lung cancer.Results Serum MCP-1,MSP and CEA levels in pulmonary tuberculosis patients and lung cancer patients were higher than those in healthy controls.Compared with lung cancer patients,patients with pulmonary tuberculosis had higher serum MCP-1 and lower CEA levels (t =2.69 and 0.89,P ＜ 0.05),but there was no significant difference in serum MSP levels between two groups (t =2.89,P ＞ 0.05).While in pleural effusion,patients with pulmonary tuberculosis had higher MCP-1 level (t =3.54,P ＜ 0.05),lower MSP and CEA levels than those with lung cancer (t =3.47 and 3.48,P ＜ 0.05).Serum MCP-1 level was of the highest specificity (95.6％) with the cut-off value of 240 pg/mL in diagnosis of pulmonary tuberculosis,while MSP level in pleural effusion was of the highest specificity (94.1％) with the cut-off value of 1100 pg/mL in diagnosis of lung cancer.Conclusion Detection of MCP-1,MSP and CEA in serum and pleural effusion can be used for the differential diagnosis of pulmonary tuberculosis and lung cancer.
出处
《中华临床感染病杂志》
CAS
2013年第6期331-334,共4页
Chinese Journal of Clinical Infectious Diseases
基金
国家自然科学基金，浙江省自然科学基金，浙江省卫生厅项目
