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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
CEA is More Useful than Cytokines in the Differential Diagnosis Distinguishing Malignant Pleural Effusion from Benign Conditions
阳光耀1 陈育民1 蔡俊明1 彭瑞鹏1
Kuang-Yao Yang, M.D., Yuh-Min Chen, M.D., Ph.D., Chun-Ming Tsai, M.D., Ph.D., Reury-Perng Perng, M.D., Ph.D.
行政院退辅会台北荣民总医院胸腔部1
Taipei Veterans General Hospital, Chest Department
Purpose:
We investigated the role of cytokines [tumor necrosis factor-a (TNF-a), interleukin-1 b (IL-1b), macrophage inflammatory proteins 1 b (MIP-1b), granulocyte-macrophage colony stimulating factor (GM-C论文范文), IL-15] in the evaluation of pleural effusion etiology.
Methods:
Using mercially-论文范文ailable ELISA kits, concentrations of these cytokines were measured in the pleural fluid and peripheral blood of patients with malignant effusions (n等于51), parapneumonic effusions (n等于7), tuberculous pleurisy (n等于8), and transudative (n等于8) effusions due to congestive heart failure or liver cirrhosis. Carcinoembryonic antigen (CEA) levels were also checked and used for parison.
Results:
The results showed that 75% of blood TNF-a and 50% of effusion TNF-a, 90% of blood IL-1b and 67.5% of effusion IL-1b, and 97.5% of blood GM-C论文范文 and 55% of effusion GM-C论文范文, were below minimal detectable concentrations, while 92.5% of blood IL-15 and 100% of effusion IL-15, and 95% of blood MIP-1b and 92.5% of effusion MIP-1b, were detectable. There was no significant difference in cytokine levels among a subgroup of patients with benign pleural effusion, in either the pleural fluid or peripheral blood; however, the pleural fluid TNF-a and IL-15 levels were higher in TB pleurisy (p等于0.048 and 0.045, respectively), and blood MIP-1b levels were lower in patients with transudates. In general, the pleural fluid cytokine levels were higher than the blood levels, if they were detectable, in both the benign and malignant effusions. However, MIP-1b was higher in the peripheral blood than in the pleural fluid in patients with malignant effusion (p等于0.009). None of these cytokines could be used for the differential diagnosis of benign and malignant pleural effusion (p>0.05), in either the pleural fluid or the peripheral blood, except for pleural fluid TNF-a, which was relatively higher in benign disease (p等于0.028). On the other hand, there were significant differences in the CEA levels in the peripheral blood (p等于0.012) and pleural fluid (p等于0.001) of benign and malignant diseases.
Conclusions:
These findings suggest that pleural fluid CEA levels are still better than cytokines for the differential diagnosis of benign and malignant pleural effusion.
第十四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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