通过检测胸腔积液中可溶性白细胞介素2受体诊断结核性胸膜炎

Diagnosis of tuberculous pleuritis by the measurement of soluble interleukin 2 receptor in pleural fluid.

作者信息

Porcel J M, Gázquez I, Vives M, Pérez B, Rubio M, Rivas M C

机构信息

Department of Internal Medicine, University Hospital Arnau de Vilanova, University of Lleida, Spain.

出版信息

Int J Tuberc Lung Dis. 2000 Oct;4(10):975-9.

PMID:11055766

Abstract

OBJECTIVE

As soluble interleukin-2 receptor (sIL-2R) is a marker of T-lymphocyte activation, we sought to determine whether its measurement in pleural fluid is diagnostically useful in tuberculous pleurisy.

DESIGN

We compared the concentrations of sIL-2R in pleural samples of 23 patients with tuberculous pleurisy and 109 patients with non-tuberculous effusions (34 malignant, 34 parapneumonic, 27 transudates and 14 miscellaneous). sIL-2R was measured by a commercial ELISA test and its performance was evaluated using receiver operating characteristic (ROC) analysis.

RESULTS

The mean values of pleural sIL-2R were 9179 U/mL in patients with tuberculous pleurisy vs 3664 U/mL in patients with malignancy, 2603 U/mL in patients with parapneumonic effusions, 1016 U/mL in patients with transudates, and 1906 U/mL in patients with miscellaneous diseases (P < 0.0001). A ROC curve identified the best cut-off at 4700 U/mL, yielding measures for sensitivity (0.91), specificity (0.94) and accuracy (0.94).

CONCLUSIONS

The results of this pilot study suggest that pleural sIL-2R appears to be clinically useful for differentiating between tuberculous and non-tuberculous pleural effusions.

摘要

目的

由于可溶性白细胞介素-2受体（sIL-2R）是T淋巴细胞活化的标志物，我们试图确定在胸腔积液中检测sIL-2R对结核性胸膜炎是否具有诊断价值。

设计

我们比较了23例结核性胸膜炎患者和109例非结核性胸腔积液患者（34例恶性肿瘤、34例类肺炎性胸腔积液、27例漏出液和14例其他疾病）胸腔样本中sIL-2R的浓度。采用商业酶联免疫吸附测定（ELISA）法检测sIL-2R，并使用受试者工作特征（ROC）分析评估其性能。

结果

结核性胸膜炎患者胸腔sIL-2R的平均值为9179 U/mL，恶性肿瘤患者为3664 U/mL，类肺炎性胸腔积液患者为2603 U/mL，漏出液患者为1016 U/mL，其他疾病患者为1906 U/mL（P < 0.0001）。ROC曲线确定最佳截断值为4700 U/mL，敏感性为0.91，特异性为0.94，准确性为0.94。