摘要
目的：探讨血清及胸腔积液中肿瘤坏死因子-α（ TNF-α）、瘦素（ LEP ）、白细胞介素-6（ IL-6）和癌胚抗原（ CEA）对结核性与恶性肿瘤的鉴别诊断价值。方法收集结核性胸膜炎患者以及恶性肿瘤患者血清与胸腔积液，分别检测TNF-α、LEP、IL-6和CEA的含量，比较结核性胸膜炎与恶性肿瘤患者血清和胸腔积液各指标的含量及阳性率。结果结核性胸膜炎患者血清TNF-α、LEP、CEA含量显著低于恶性肿瘤患者[（34．45±17．11）μg／L 比（70．26±19．31）μg／L，（490．71±197．58）μg／L 比（2013．62±596．22）μg／L，（226.81±87．09）μg／L比（5329．62±1523．58）μg／L，t＝5．221、9．673、12．078，P＝0．012、0．031、0．000]，而IL-6则相反[（159．73±30．33）μg／L比（22．31±3．20）μg／L，t＝-16．114，P＝0．001]；结核性胸膜炎患者胸腔积液TNF-α、LEP、CEA含量显著低于恶性肿瘤患者[（20．31±5．62）μg／L比（42．06±14．07）μg／L，（702．46± 375．01）μg／L比（4532．27±2307．83）μg／L，（112．25±48．72）μg／L比（4190．84±1534．29）μg／L，t＝5．017、12．096、12．236，P＝0．022、0．016、0．033]，而IL-6则相反[（92．15±32．64）μg／L比（10．29±3．91）μg／L，t＝－11．583，P＝0．031]。结核性胸膜炎患者血清TNF-α、LEP、CEA阳性率显著低于恶性肿瘤患者（17．8％比72．2％，20．0％比91．7％，0．0％比100．0％，χ2＝24．341、41．145、81．000，P＝0．000、0．000、0．000），而IL-6则相反（100．0％比0．0％，χ2＝81．000，P＝0．000）；结核性胸膜炎患者胸腔积液TNF-α、LEP、CEA阳性率显著低于恶性肿瘤患者（28．9％比75．0％，4．4％比100．0％，0．0％比97．2％；χ2＝17.012、73．326、77．038，P＝0.000、0．000、0．000），而IL-6则相反（97．8％比0．00％，χ2＝77．059，P＝0．000）。结论肿瘤患者血清与胸�
Objective To evaluate the value of tumor necrosis factor -α（ TNF-α） ,leptin （ LEP） ,interleu-kin-6 （IL-6） and carcinoma embryonic antigen （CEA） in both serum and pleural effusion in differential diagnosis of tuberculosis and malignant tumor .Methods Detection were performed on tuberculosis and malignant tumor patients,comparation was conducted on the level and positive ratio of TNF -α,LEP,IL -6 and CEA in different groups.Results The levels of TNF-α,LEP,CEA in serum decreased significantly compared with malignant tumor patients[（34.45 ±17.11）μg/L vs （70.26 ±19.31）μg/L,（490.71 ±197.58）μg/L vs （2 013.62 ±596.22）μg/L, （226.81 ±87.09）μg/L vs （5 329.62 ±1 523.58）μg/L;t=5.221,9.673,12.078;P=0.012,0.031,0.000],but IL-6 was not [（159.73 ±30.33）μg/L vs （22.31 ±3.20）μg/L;t=-16.114;P=0.001];The level of TNF-α, LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients [（ 20.31 ± 5.62）μg/L vs （42.06 ±14.07）μg/L,（702.46 ±375.01）μg/L vs （4 532.27 ±2 307.83）μg/L,（112.25 ± 48.72）μg/L vs （4 190.84 ±1 534.29）μg/L;t=5.017,12.096,12.236;P=0.022,0.016,0.033],but IL-6 was not [（92.15 ±32.64）μg/L vs （10.29 ±3.91）μg/L,t=-11.583;P=0.031].The positive ratio of TNF -α, LEP,CEA in serum was decreased significantly compared with malignant tumor patients （17.8% vs 72.2%,20.0%vs 91.7%,0.0% vs 100.0%;χ2 =24.341,41.145,81.000;P =0.000,0.000,0.000）,but IL -6 was not （100.0%vs 0.0%,χ2 =81.000;P=0.000）;The positive ratio of TNF -α,LEP,CEA in pleural effusion was decreased significantly compared with malignant tumor patients （28.9% vs 75.0%,4.4% vs 100.0%,0.0% vs 97.2%;χ2 =17.012,73.326,77.038;P=0.000,0.000,0.000）,but IL -6 was not（97.8% vs 0.0%,χ2 =77.059;P=0.000）.Conclusion The level and positive ratio of malignant tumor patients are higher than tuberculo-sis patients,but IL-6 is not,these indicators are helpful in diagnosing tuberculosis and malignant tumor .
出处
《中国基层医药》
CAS
2015年第6期804-808,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
黑龙江省自然科学基金项目（H2013004）
