[腺苷脱氨酶活性在结核性胸膜炎诊断价值的评估]

[Evaluation of the diagnostic value of adenosine deaminase activity in tuberculous pleuritis].

作者信息

Yu Yan-xia, Tong Zhao-hui, Gong Juan-ni, Wang Zhen, Wang Xiao-juan, Xu Li-li, Wu Yan-bing, Li Hong-jie, Wang Chen

机构信息

Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2010 Apr;33(4):273-5.

PMID:20646458

Abstract

OBJECTIVE

To investigate the clinical value of pleural fluid adenosine deaminase (ADA) activity in differentiating tuberculous pleural effusions (TPE) from malignant effusions.

METHODS

The serum and pleural adenosine deaminase activity of 91 cases confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed. TPE was confirmed in 49 cases and malignant effusion in 42 cases. The optimal cutoff for TPE was determined by using the ROC curve.

RESULTS

The mean pleural ADA was significantly (t = 7.383, P < 0.01) higher in PTE (46 +/- 26) U/L as compared to malignancy (16 +/- 8) U/L, so was the pleural fluid/serum ADA ratio (4.1 +/- 4.0 vs 1.76 +/- 1.2, t = 3.852, P < 0.01), but there was no statistically significant difference between malignant and tuberculous effusion in serum ADA activity [(13 +/- 5) U/L vs (12 +/- 6) U/L, t = 1.582, P > 0.05]. The cutoff value of pleural ADA for PTE was 28.7 U/L, with a sensitivity of 75.5% and a specificity of 95.2%.

CONCLUSIONS

Pleural fluid, but not serum, ADA activity, can be used for the differentiation between tuberculous and malignant pleural effusions.

摘要

目的

探讨胸腔积液腺苷脱氨酶（ADA）活性在鉴别结核性胸腔积液（TPE）与恶性胸腔积液中的临床价值。

方法

回顾性分析91例经内科胸腔镜胸膜活检确诊患者的血清及胸腔积液腺苷脱氨酶活性。其中49例确诊为TPE，42例为恶性胸腔积液。采用ROC曲线确定TPE的最佳截断值。

结果

结核性胸膜炎组胸腔ADA均值（46±26）U/L显著高于恶性胸腔积液组（16±8）U/L（t = 7.383，P < 0.01），胸腔积液/血清ADA比值也显著高于恶性胸腔积液组（4.1±4.0 vs 1.76±1.2，t = 3.852，P < 0.01），但血清ADA活性在恶性胸腔积液组与结核性胸腔积液组之间差异无统计学意义[（13±5）U/L vs（12±6）U/L，t = 1.582，P > 0.05]。结核性胸膜炎胸腔ADA的截断值为28.7 U/L，敏感性为75.5%，特异性为95.2%。