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目的探讨胸腔积液中的肿瘤坏死因子(TNF-α)水平对结核性胸膜炎与肺癌鉴别诊断的意义。方法肺结核合并胸腔积液患者53例,男32例,女21例;肺癌合并胸腔积液患者61例,男45例,女16例;正常对照组55例,男31例,女24例。所有标本用酶联免疫吸附试验(ELISA)方法测定TNF-α浓度,数据经SPSS 11.0统计软件,行方差分析齐性检验后,再行t检验。结果肺结核胸腔积液组TNF-α水平为(36.38±4.73)ng/L,肺癌并胸腔积液组TNF-α水平为(11.42±2.57)ng/L,肺癌患者胸腔积液中TNF-α含量低于结核性胸腔积液(t=35.63,P<0.001)。外周血TNF-α水平对照组与患病组比较,对照组外周血TNF-α水平为(11.75±1.94)ng/L,肺癌组TNF-α水平为(28.43±4.11)ng/L,肺结核组TNF-α水平为(13.88±2.33)ng/L,亦有统计学意义(t=27.46,P<0.01)。结论对肺癌及肺结核患者胸腔积液中和外周血中TNF-α的水平进行检测,对两者的诊断及鉴别诊断有一定意义。
Objective To investigate the significance of the level of tumor necrosis factor (TNF-α) in pleural effusion on the differential diagnosis of tuberculous pleurisy and lung cancer. Methods Fifty-three patients with pulmonary tuberculosis complicated with pleural effusion, 32 males and 21 females; 61 patients with lung cancer with pleural effusion, 45 males and 16 females; and 55 normal controls, 31 males and 24 females. All samples were measured by enzyme-linked immunosorbent assay (ELISA) method of TNF-α concentration data by SPSS 11.0 statistical software, analysis of variance homogeneity test, then t test. Results The level of TNF-α in tuberculosis pleural effusion group was (36.38 ± 4.73) ng / L, the level of TNF-α in lung cancer group was (11.42 ± 2.57) ng / L, the level of TNF-α in pleural effusion Lower than tuberculous pleural effusion (t = 35.63, P <0.001). The level of TNF-α in peripheral blood was (11.75 ± 1.94) ng / L in the control group and (28.43 ± 4.11) ng / L in the lung cancer group, The level of TNF-α was (13.88 ± 2.33) ng / L, which was also statistically significant (t = 27.46, P <0.01). Conclusion The detection of TNF-α in pleural effusion and peripheral blood in patients with lung cancer and pulmonary tuberculosis has some significance in the diagnosis and differential diagnosis of both.