[1]王景民,马曼曼,高孟秋.结核感染T细胞斑点试验在鉴别结核性与恶性胸腔积液中的价值研究[J].陕西医学杂志,2021,50(9):1147-1149，1153.[doi:DOI:10.3969/j.issn.1000-7377.2021.09.026]
点击复制

结核感染T细胞斑点试验在鉴别结核性与恶性胸腔积液中的价值研究
分享到：

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年9期
页码:
1147-1149，1153
栏目:
临床检验
出版日期:
2021-09-05

文章信息/Info

作者:
王景民1; 马曼曼2; 高孟秋3
(1.陕西省结核病防治院 陕西省第五人民医院内镜中心,陕西 西安 710100; 2.陕西省结核病防治院 陕西省第五人民医院感染办公室,陕西 西安 710100; 3.首都医科大学附属北京胸科医院结核二科,北京 101149)
关键词:
结核性胸腔积液;  恶性胸腔积液;  结核感染T细胞斑点试验;  早期分泌抗原靶蛋白-6;  培养滤液蛋白-10
分类号:
R 529.3
DOI:
DOI:10.3969/j.issn.1000-7377.2021.09.026
文献标志码:
A
摘要:
目的:探究结核感染T细胞斑点试验(T-SPOT.TB)在鉴别结核性和恶性胸腔积液中的价值。方法:选取胸腔积液患者407例为研究对象,分为结核性胸腔积液组(328例)和恶性肿瘤胸腔积液组(79例)。比较两组患者胸腔积液T-SPOT.TB、外周血T-SPOT.TB检测结果及胸腔积液与外周血T-SPOT.TB差值。通过受试者工作特征曲线(ROC)分析胸腔积液T-SPOT.TB、外周血T-SPOT.TB及胸腔积液与外周血T-SPOT.TB差值对结核性和恶性肿瘤胸腔积液的鉴别诊断效能。结果:结核性胸腔积液组胸腔积液中早期分泌抗原靶蛋白-6(ESAT-6)、培养滤液蛋白-10(CFP-10)及ESAT-6+CFP-10斑点形成细胞(SFC)数量高于恶性肿瘤胸腔积液组(均P<0.05)。结核性胸腔积液组外周血中ESAT-6、CFP-10及ESAT-6+CFP-10 SFC数量高于恶性肿瘤胸腔积液组(均P<0.05)。结核性胸腔积液组胸腔积液ESAT-6+CFP-10与外周血ESAT-6+CFP-10 SFC数量差值高于恶性肿瘤胸腔积液组(P<0.05)。ROC曲线分析显示,胸腔积液T-SPOT.TB检测结果曲线下面积(AUC)高于外周血T-SPOT.TB。结论:胸腔积液较外周血T-SPOT.TB对结核性胸腔积液的辅助诊断价值更高。胸腔积液T-SPOT.TB与外周血T-SPOT.TB检测结果差值对鉴别结核性胸膜积液和恶性胸腔积液有较高辅助诊断价值。

参考文献/References:

[1] 全国结核病流行病学抽样调查技术指导小组.第四次全国结核病流行病学抽样调查报告[J].中华结核和呼吸杂志,2002,25(1):3-7.
[2] Liam CK,Lim KH,Wong CM.Causes of pleural exudates in a region with a high incidence of tuberculosis[J].Res Pirology,2000,5:28-33.
[3] Sester M,Sotgiu G,Lange C,et al.Interferon γ-release assays for the diagnosis of active tuberculosis:A systematic review and meta-analysis[J].Eur Respir J,2011,37:100-111.
[4] Escudero BC,García CM,Cuesta CB,et al.Cytologic and bacteriologic analysis of fluid and pleural biopsy specimens with Cope's needle:Study of 414 patients[J].Arch Intern Med,1990,150(6):1190-1194.
[5] Valdés L,Alvarez D,San JE,et al.Tuberculous pleurisy:A study of 254 patients[J].Arch Intern Med,1998,158:2017-2021.
[6] La LA.Diagnosing tuberculosis infection in the 21st century:New tools to tackle an old enemy[J].Chest,2007,131:1898-1906.
[7] Pai M,Zwer LA,Menzies D.Systematic review:T-cell-based assays for the diagnosis of latent tuberculosis infection:An update[J].Ann Intern Med,2008,149:177-184.
[8] 中华人民共和国国家卫生和计划生育委员会.肺结核诊断标准(WS 288-2017)[J].新发传染病电子杂志,2018,3(1):59-61.
[9] Kastelik JA.Management of malignant pleural effusion[J].Lung,2013,191(2):165-175.
[10] Lei X,Wang J,Yang Z,et al.Diagnostic value of pleural effusio mononuclear cells count and adenosine deaminase for tuberculous pleurisy patients in China:A case-control study[J].Front Med,2019,6:301.
[11] Dixon G,Fonseka DD,Maskell N.Pleural controversies:Image guided biopsy vs.thoracoscopy for undiagnosed pleural effusions[J].Journal of Thoracic Disease,2015,7(6):1041-1051.
[12] Rahman NM,Ai NJ,Brow G,et al.Local anaesthetic thoracoscopy:British thoracic society pleural disease guideline 2010[J].Thorax,2010,65(Suppl 2):54-60.
[13] Gopi A,Madhavan SM,Sharma SK,et al.Diagnosis and treatment of tuberculous pleural effusion in 2006[J].Chest,2007,131(3):880-889.
[14] Zhou XX,Liu YL,Zhai K,et al.Body fluid interferon-γ release assay for diagnosis of extrapulmonary tuberculosis in adults:A systematic review and meta-analysis[J].Scientific Reports,2015,5:15284.
[15] Luo Y,Tan Y,Yu J,et al.The peformance of pleural fluid T-SPOT.TB assay for diagnosing tuberculous pleurisy in China:A two-center prospective cohort study[J].Front Cell Infect Microbiol,2019,9:10.
[16] 田红英,符兆英.SELEX技术的原理和核酸适配体在医学上的应用进展[J].细胞与分子免疫学杂志,2012,28(10):1103-1106.
[17] 韩小东,符兆英,郭姝彤,等.核酸适配体筛选方法研究进展[J].陕西医学杂志,2018,47(3):407-408.
[18] Pang CS,Shen YC.Tian PW,et al.Accuracy of the interferon-gamma release assay for the diagnosis of tuberculous pleurisy:An updated meta-analysis[J].Peer J,2015,3:e951.
[19] Li ZZ,Qin WZ,Li L,et al.Accuracy of enzyme-linked immunospot assay for diagnosis of pleural tuberculosis:A meta-analysis[J].Genet Mol Res,2015,14(3):11672-11680.
[20] 许利芳,胡 克.胸腔积液结核感染T细胞斑点试验诊断结核性胸膜炎的Meta分析[J].临床内科杂志,2016,33(10):675-678.
[21] 李慧敏,马清光,李洪英.胸腔积液γ-干扰素释放试验对结核性胸腔积液诊断价值的Meta分析[J].检验医学,2018,33(2):139-146.
[22] Aggarwal AN,Agarwal R,Gupta D,et al.Interferon gamma release assays for diagnosis of pleural tuberculosis:A systematic review and meta-analysis[J].J Clin Microbiol,2015,53(8):2451-2459.
[23] Losi M,Bossink A,Codecasa L,et al.Use of a T-cell interferon-gamma release assay for the diagnosis of tuberculous pleurisy[J].Eur Respir J,2007,30:1173-1179.
[24] 贾红彦,潘丽萍,杨新婷,等.两种γ-干扰素释放试验在结核性胸膜炎中的辅助诊断价值[J].北京医学,2018,4(4):297-300.

相似文献/References:

[1]郭倩倩,苏志勇.乳腺癌术后恶性胸腔积液临床特征及预后Cox回归分析[J].陕西医学杂志,2024,(2):203.[doi:DOI:10.3969/j.issn.1000-7377.2024.02.012]

更新日期/Last Update: 2021-09-06