联合检测胸腔积液中Midkine、胸腔积液腺苷脱氨酶及胸腔积液糖类抗原125在鉴别非小细胞肺癌相关恶性胸腔积液中的临床价值

Clinical value of jointly detection pleural fluid Midkine, pleural fluid adenosine deaminase, and pleural fluid carbohydrate antigen 125 in the identification of nonsmall cell lung cancer-associated malignant pleural effusion.

作者信息

Zhang Fan, Wang Junjun, Zheng Xiaoyong, Hu Lijuan, Chen Jie, Jiang Feng, Wang Yumin

机构信息

Department of Laboratory Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Department of ICU, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

J Clin Lab Anal. 2018 Oct;32(8):e22576. doi: 10.1002/jcla.22576. Epub 2018 May 23.

DOI:10.1002/jcla.22576

PMID:29797475

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6817252/

Abstract

BACKGROUND

Midkine (MK) level has been shown to be elevated in serum of patients with nonsmall cell lung cancer (NSCLC). However, the diagnostic value of MK in pleural effusion in NSCLC has not been well validated and established.

METHODS

Samples of NSCLC-associated malignant pleural effusions (MPE) and benign effusions (BPE) were collected. The pleural fluid MK (pMK), pleural fluid adenosine deaminase (pADA), pleural fluid lactate dehydrogenase (pLDH), pleural fluid glucose (pGLU), pleural fluid ferritin (pFER), pleural fluid CA199 (pCA199), pleural fluid CA125 (pCA125), pleural effusion white cell count (pWBC), and pleural effusion red cell count (pRBC) were analyzed, and the clinical data of each group were collected for statistical analysis.

RESULT

The level of pMK, pCA125, pMK + pCA125, and pMK + pCA125 + pADA in the MPE was significantly higher than the BPE group (P = .003, .000, .000, .000). The pADA level in the BPE was significantly higher than the MPE group (P = .003). It showed that the area under the ROC curve (AUC) (0.816) of jointly detection pMK, pCA125, and pADA was significantly higher than other markers for the diagnosis of MPE. Therefore, joint detection of pMK + pCA125 + pADA suggested that the sensitivity, specificity, and AUC was 82.54%, 74.19% at the cutoff 0.47 and diagnostic performance was higher than others.

CONCLUSION

Joint detection of pMK + pCA125 + pADA can be used as a good indicator for the identification of MPE of NSCLC.

摘要

背景

已表明非小细胞肺癌（NSCLC）患者血清中的中期因子（MK）水平升高。然而，MK在NSCLC胸腔积液中的诊断价值尚未得到充分验证和确立。

方法

收集NSCLC相关恶性胸腔积液（MPE）和良性胸腔积液（BPE）样本。分析胸腔积液MK（pMK）、胸腔积液腺苷脱氨酶（pADA）、胸腔积液乳酸脱氢酶（pLDH）、胸腔积液葡萄糖（pGLU）、胸腔积液铁蛋白（pFER）、胸腔积液CA199（pCA199）、胸腔积液CA125（pCA125）、胸腔积液白细胞计数（pWBC）和胸腔积液红细胞计数（pRBC），并收集每组的临床数据进行统计分析。

结果

MPE组中pMK、pCA125、pMK + pCA125和pMK + pCA125 + pADA水平显著高于BPE组（P = 0.003、0.000、0.000、0.000）。BPE组中pADA水平显著高于MPE组（P = 0.003）。结果显示，联合检测pMK、pCA125和pADA的ROC曲线下面积（AUC）（0.816）显著高于其他用于诊断MPE的标志物。因此，联合检测pMK + pCA125 + pADA表明，在临界值为０.４７时，敏感性、特异性和AUC分别为82.54%、74.19%，诊断性能高于其他指标。