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胚胎绒毛抗原(CEA)比细胞激素对区别良性与恶性肋膜积水的监别诊断有所助益
CEAisMoreUsefulthanCytokinesintheDifferentialDiagnosisDistinguishingMalignantPleuralEffusionfromBenignConditions
阳光耀1陈育民1蔡俊明1彭瑞鹏1
Kuang-YaoYang,M.D.,Yuh-MinChen,M.D.,Ph.D.,Chun-MingTsai,M.D.,Ph.D.,Reury-PerngPerng,M.D.,Ph.D.
行政院退辅会台北荣民总医院胸腔部1
TaipeiVeteransGeneralHospital,ChestDepartment
Purpose:
Weinvestigatedtheroleofcytokines[tumornecrosiactor-a(TNF-a),interleukin-1b(IL-1b),macrophageinflammatoryproteins1b(MIP-1b),granulocyte-macrophagecolonystimulatingfactor(GM-C),IL-15]intheevaluationofpleuraleffusionetiology.
Methods:
Usingmercially-ailableELISAkits,concentrationsofthesecytokinesweremeasuredinthepleuralfluidandperipheralbloodofpatientswithmalignanteffusions(n等于51),parapneumoniceffusions(n等于7),tuberculouspleurisy(n等于8),andtransudative(n等于8)effusionsduetocongestiveheartfailureorlivercirrhosis.Carcinoembryonicantigen(CEA)levelswerealsocheckedandusedforparison.
Results:
Theresultsshowedthat75%ofbloodTNF-aand50%ofeffusionTNF-a,90%ofbloodIL-1band67.5%ofeffusionIL-1b,and97.5%ofbloodGM-Cand55%ofeffusionGM-C,werebelowminimaldetectableconcentrations,while92.5%ofbloodIL-15and100%ofeffusionIL-15,and95%ofbloodMIP-1band92.5%ofeffusionMIP-1b,weredetectable.Therewasnosignificantdifferenceincytokinelevelsamongasubgroupofpatientswithbenignpleuraleffusion,ineitherthepleuralfluidorperipheralblood,however,thepleuralfluidTNF-aandIL-15levelswerehigherinTBpleurisy(p等于0.048and0.045,respectively),andbloodMIP-1blevelswerelowerinpatientswithtransudates.Ingeneral,thepleuralfluidcytokinelevelswerehigherthanthebloodlevels,iftheyweredetectable,inboththebenignandmalignanteffusions.However,MIP-1bwashigherintheperipheralbloodthaninthepleuralfluidinpatientswithmalignanteffusion(p等于0.009).Noneofthesecytokinescouldbeusedforthedifferentialdiagnosisofbenignandmalignantpleuraleffusion(p>,0.05),ineitherthepleuralfluidortheperipheralblood,exceptforpleuralfluidTNF-a,whichwasrelativelyhigherinbenigndisease(p等于0.028).Ontheotherhand,thereweresignificantdifferencesintheCEAlevelsintheperipheralblood(p等于0.012)andpleuralfluid(p等于0.001)ofbenignandmalignantdiseases.
Conclusions:
ThesefindingssuggestthatpleuralfluidCEAlevelsarestillbetterthancytokineorthedifferentialdiagnosisofbenignandmalignantpleuraleffusion.
第十届海峡两岸肿瘤学术会议论文投稿ABSTRACT
性质:□基础□转译□临床
□转译
□临床
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第一作者中文姓名:传真::手机:E-mail: