[C-C趋化因子在胸腔积液病因诊断中的作用]

[Role of c-c chemokines in the determination of pleural effusion etiology].

作者信息

Trzaska-Sobczak Marzena, Pierzchała Władysław, Brozek Grzegorz, Farnik Małgorzata

机构信息

Z Katedry i Kliniki Pneumonologii oraz, Slaskiego Uniwersytetu Medycznego w Katowicach.

出版信息

Wiad Lek. 2008;61(7-9):190-4.

PMID:19172830

Abstract

UNLABELLED

The purpose of the study was to evaluate predictive value of vascular endothelial growth factor (VEGF) in the differential diagnosis of pleural effusion.

MATERIAL AND METHODS

By Light's criteria in 29 cases exudates and 10 transudates was recognized. We investigated 39 patients with pleural effusion (congestive heart failure--10, parapneumonic--11, tuberculous--6, malignant--12, transudate--10).

RESULTS

The mean VEGF value were significantly higher (p = 0.002) in the effusion of lung cancer patient (3958.33 pg/ml) than in the serum (1030.33 pg/ml). The mean VEGF levels were significantly higher (p = 0.004) in patient with exudates (2711.10 pg/ml) than in transudates (683 pg/ml). Based on the receiver operating characteristic (ROC) curve analysis, cut off value in differentiation of exudates and transudates was accepted at the level of 560 pg/ml (sensitivity 80% and specificity 70%). The mean VEGF levels were significantly higher (p = 0.008) in the malignant effusion (3958.33 pg/ml) than in the tuberculous effusion (1308.90 pg/ml). Based on the ROC curve analysis, cut off value in differentiation of malignant and tuberculous effusion was accepted at the level of 2000 pg/ml (sensitivity 92% and specificity 83%). The positive correlation between pleural VEGF concentrations and pleural lactate dehydrogenase (LDH) level were observed (r = 0.67, p < 0.05).

CONCLUSION

We conclude that pleural effusion VEGF level could be useful in the differentiation between exudates and transudate and also between malignant and tuberculous exudates.

摘要

未标记

本研究的目的是评估血管内皮生长因子（VEGF）在胸腔积液鉴别诊断中的预测价值。

材料与方法

根据Light标准识别出29例渗出液和10例漏出液。我们研究了39例胸腔积液患者（充血性心力衰竭10例、肺炎旁积液11例、结核性6例、恶性12例、漏出液10例）。

结果

肺癌患者胸腔积液中VEGF的平均水平（3958.33 pg/ml）显著高于血清中的水平（1030.33 pg/ml）（p = 0.002）。渗出液患者的VEGF平均水平（2711.10 pg/ml）显著高于漏出液患者（683 pg/ml）（p = 0.004）。根据受试者工作特征（ROC）曲线分析，渗出液与漏出液鉴别的截断值为560 pg/ml（敏感性80%，特异性70%）。恶性胸腔积液的VEGF平均水平（3958.33 pg/ml）显著高于结核性胸腔积液（1308.90 pg/ml）（p = 0.008）。根据ROC曲线分析，恶性与结核性胸腔积液鉴别的截断值为2000 pg/ml（敏感性92%，特异性83%）。观察到胸腔VEGF浓度与胸腔乳酸脱氢酶（LDH）水平呈正相关（r = 0.67，p < 0.05）。