| 摘要: |
| ［摘要］ 目的 探讨肿瘤标志物内皮细胞特异因子-1（ESM-1）、基质金属蛋白酶-2（MMP-2）和基质金属蛋白酶-9（MMP-9）鉴别良恶性胸腔积液的临床意义。方法 选择2018年1月至2019年3月暨南大学附属广州红十字会医院心胸外科收治的胸腔积液患者99例，其中恶性胸腔积液患者53例（恶性胸腔积液组），良性胸腔积液患者46例（良性胸腔积液组）。采用酶联免疫吸附法(ELISA)检测患者胸腔积液中ESM-1、MMP-2和MMP-9的水平。应用受试者工作特征（ROC）曲线分析ESM-1、MMP-2和MMP-9鉴别良恶性胸腔积液的诊断效能。结果 恶性胸腔积液组胸腔积液ESM-1、MMP-2和MMP-9水平显著高于良性胸腔积液组（P<0.05）。恶性胸腔积液患者的病理类型、T分期与胸腔积液ESM-1、MMP-2、MMP-9的水平存在显著关联（P<0.05）；远隔器官转移情况与MMP-2、MMP-9水平存在显著关联（P<0.05），而与ESM-1关联性不显著（P>0.05）。ROC曲线分析结果显示，ESM-1、MMP-2和MMP-9均具有鉴别良恶性胸腔积液的诊断价值（P<0.05），其截断值分别为40.110 ng/ml、446.690 ng/ml和145.560 ng/ml。将ESM-1、MMP-2和MMP-9进行联合诊断，结果显示，MMP-2+MMP-9组合获得的灵敏度最高（96.2%），MMP-2+ESM-1组合获得的特异度最高（89.1%），而ESM-1+MMP-2+MMP-9组合的诊断效能最优（AUC=0.928）。结论 恶性胸腔积液中ESM-1、MMP-2和MMP-9表达水平显著增高，可作为鉴别良恶性胸腔积液的指标，三者联合诊断效能更优。 |
| 关键词: 胸腔积液 内皮细胞特异因子-1 基质金属蛋白酶-2 基质金属蛋白酶-9 鉴别诊断 |
| DOI：10.3969/j.issn.1674-3806.2021.10.16 |
| 分类号:R 561 |
| 基金项目:广州市科技计划项目（编号：201604020063，201902010003） |
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| Clinical significances of tumor markers ESM-1, MMP-2 and MMP-9 in differentiating benign and malignant pleural effusions |
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LIU Qing-feng, WU Wei-dong, GU Jia-sheng, et al.
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Department of Cardiothoracic Surgery, Guangzhou Red Cross Hospital Affiliated to Jinan University, Guangdong 510220, China
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| Abstract: |
| ［Abstract］ Objective To explore the clinical significances of tumor markers endothelial cell specific molecule-1(ESM-1), matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9(MMP-9) in differentiating benign and malignant pleural effusions. Methods Ninety-nine pleural effusion patients admitted to the Department of Cardiothoracic Surgery, Guangzhou Red Cross Hospital Affiliated to Jinan University from January 2018 to March 2019 were selected, including 53 patients with malignant pleural effusion(malignant pleural effusion group) and 46 patients with benign pleural effusion(benign pleural effusion group). Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of ESM-1, MMP-2 and MMP-9 in the patients′ pleural effusion. The receiver operator characteristic(ROC) curve was used to analyze the diagnostic efficacy of ESM-1, MMP-2 and MMP-9 in differentiating benign and malignant pleural effusions. Results The levels of ESM-1, MMP-2 and MMP-9 in pleural effusion in the malignant pleural effusion group were significantly higher than those in the benign pleural effusion group(P<0.05). The pathological type and T stage of patients with malignant pleural effusion were significantly correlated with the levels of ESM-1, MMP-2, and MMP-9 in pleural effusion(P<0.05). The metastasis of distant organs had a significant relationship with the levels of MMP-2 and MMP-9(P<0.05), but did not have a significant relationship with the level of ESM-1(P>0.05). The results of ROC curve analysis showed that ESM-1, MMP-2 and MMP-9 had diagnostic value in differentiating benign and malignant pleural effusions(P<0.05), and their cut-off values were 40.110 ng/ml, 446.690 ng/ml and 145.560 ng/ml, respectively. The results of the combined diagnosis of ESM-1, MMP-2 and MMP-9 showed that the combination of MMP-2+MMP-9 had the highest sensitivity(96.2%), and the combination of MMP-2+ESM-1 had the highest specificity( 89.1%), and the combination of ESM-1+MMP-2+MMP-9 had the best diagnostic performance［area under the curve(AUC)=0.928］. Conclusion The expression levels of ESM-1, MMP-2 and MMP-9 in malignant pleural effusion are significantly increased, which can be used as indicators to differentiate benign from malignant pleural effusions. The combined diagnosis of the three tumor markers is more effective. |
| Key words: Pleural effusion Endothelial cell specific molecule-1(ESM-1) Matrix metalloproteinase-2(MMP-2) Matrix metalloproteinase-9(MMP-9) Differential diagnosis |
