Xu Zhiyang, Guan Jun, Xu Jianxin, Tu Jiahua, Cheng Jiangdong
Department of Thoracic Surgery, The Third Clinical Medical College of Fujian Medical University, The First Hospital of Putian, Putian 351100, Fujian, China.
Emerg Med Int. 2022 Aug 29;2022:1615058. doi: 10.1155/2022/1615058. eCollection 2022.
The aim of the study is to investigate the clinical value of matrix metalloproteinases-3 (MMP-3) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) combined with adenosine deaminase (ADA) in pleural effusion and serum in benign and malignant pleural exudative effusion (PEE).
A total of 119 adult patients with PEE admitted in our hospital from May 2018 to October 2021 were selected. According to the patient's condition, the patients were divided into the benign group ( = 75) and the malignant group ( = 44). The levels of MMP-3, CYFRA21-1, and ADA in pleural effusion and serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the individual and combined predictive value of MMP-3, CYFRA21-1, and ADA levels.
In the malignant group, the pleural effusion and serum MMP-3 and CYFRA21-1 levels were higher than those in the benign group and the ADA levels were lower than those in the benign group ( < 0.05). In the malignant group, the positive detection rate of pleural effusion and serum MMP-3 and CYFRA21-1 was higher than that in the benign group and the positive detection rate of pleural effusion and serum ADA were lower than that in the benign group ( < 0.05). The AUC of pleural effusion MMP-3, serum MMP-3 and the combination of them in the diagnosis of PEE were 0.764, 0.722 and 0.810, respectively. The AUC of pleural effusion CYFRA21-1 and serum CYFRA21-1 and combination of them in the diagnosis of PEE were 0.776, 0.748 and 0.822, respectively. The AUC of pleural effusion ADA, serum ADA and their combination in differential diagnosis of PEE were 0.762, 0.737 and 0.836, respectively. The AUC of pleural effusion and serum of MMP-3 and CYFRA21-1 combined with ADA for differential diagnosis of PEE was 0.923.
The diagnostic efficacy of MMP-3 combined with CYFRA21-1 and ADA in pleural effusion and serum for benign and malignant PEE are better than single index, which has certain clinical values for the selection of early intervention scheme for PEE patients.
本研究旨在探讨基质金属蛋白酶-3（MMP-3）、细胞角蛋白19片段抗原21-1（CYFRA21-1）联合腺苷脱氨酶（ADA）检测在良恶性胸腔积液患者胸腔积液及血清中的临床价值。
选取2018年5月至2021年10月在我院住院治疗的119例成年胸腔积液患者。根据病情将患者分为良性组（n = 75）和恶性组（n = 44）。检测胸腔积液及血清中MMP-3、CYFRA21-1和ADA水平。采用受试者工作特征（ROC）曲线分析MMP-3、CYFRA21-1和ADA水平的单项及联合预测价值。
恶性组胸腔积液及血清中MMP-3和CYFRA21-1水平高于良性组，ADA水平低于良性组（P < 0.05）。恶性组胸腔积液及血清中MMP-3和CYFRA21-1的阳性检出率高于良性组，胸腔积液及血清中ADA的阳性检出率低于良性组（P < 0.05）。胸腔积液MMP-3、血清MMP-3及其联合检测诊断胸腔积液的AUC分别为0.764、0.722和0.810。胸腔积液CYFRA21-1、血清CYFRA21-1及其联合检测诊断胸腔积液的AUC分别为0.776、0.748和0.822。胸腔积液ADA、血清ADA及其联合检测鉴别诊断胸腔积液的AUC分别为0.762、0.737和0.836。胸腔积液及血清中MMP-3、CYFRA21-1联合ADA鉴别诊断胸腔积液的AUC为0.923。
MMP-3联合CYFRA21-1和ADA检测胸腔积液及血清对良恶性胸腔积液的诊断效能优于单项指标，对胸腔积液患者早期干预方案的选择具有一定的临床价值。
