Investigate The Diagnostic Value Of Joint Detection With E-SLT, ADA, TB-Ab-lgG, CEA And LDH For Tuberculous And Cancer Pleural Effusion

Objective: To discuss the value of examining E-SLT, ADA, TB-IgG, CEA and LDH in diagnosing tuberculous pleural effusion and cancerous pleural effusion. Methods: 81 patients including 33 tuberculous pleurisy, 30 cancerous pleural effusion and 18 healthy patients were randomly allocated into three groups: tuberculous pleural effusion group (group I), cancerous pleural effusion group II (group II) and control group (group III). Results: (1)The concerntration of plasma E-selectin in group I, II and III were 48.77±18.27 ng/ml, 26.49±7.19ng/ml, 12.17±1.67ng/ml respectively which showed significant differences between each groups (p<0.01); The concerntration of E-selectin in pleural effusion in group I and II were 46.56±15.00ng/ml and 19.16±3.45ng/ml which were statistically different (p<0.01). (2) The concerntration of plasma ADA and pleural effusion ADA in group I and group II were respectively 33.00±7.59 U/L, 24.72±6.98 U/L and 51.96±9.87U/L, 21.98±5.47U/L which were both significantly different (p<0.001). P/S in group I were 1.61±0.28 >2,while in group II were 0.94±0.22 <1. (3) The concerntration of plasm CEA and pleural effusion CEA in group I and group II were respectively 2.98±0.96μg/mL, 5.68±2.04μg/mL and 3.46±1.02μg/mL, 32.66±19.23μg/mL which both presented to be significantly different (p<0.001). P/S in group II were 1.27±0.51. (4) The number of positive TB-Ab-IgG patients of plasma in group I and group II were 23 and 4 respectively, which showed significant difference (p<0.001). The number of positive TB-Ab-IgG of pleural effusion patients in group I and group II were 30 and 0 respectively, which showed significant difference (p<0.001). There were significant differences of TB-Ab-IgG in plasma and pleural effusion. (5) The concentraion of LDH is in plasma is 220.78±37.11U/L, 228.76±64.65U/L From stastistic point of view, no dramatic difference is found in group I and group II , P> 0.05. The concentraion of LDH in pleural effusion in group I and group II is 430.10±104.87 U/L, 447.36±89.83U/L individually, no big diffenrence between groupI and group II as statistic way. This shows no LDH active quality difference is confrimed in plasma and pleural effusion (group II). There is no meaning to diagnosis and differentiated diagnosis to TB and cancerous pleural effusion only according to this standard. P/S in cancerous pleural effusion group is 2.02±0.32, >2. All these follow the cancerous pleural effusion diagnostic standard of P/SLDH>2, which is reported by reference material. So checking LDH still has meaning for diagnosis and differenriaed diagnosis to TB and cancerous pleural effusion. (6) The specificity of diagnosing by joint detection E-SLT, ADA, TB-IgG in tuberculous pleural effusion were 97.0% and 93.3% respectively, validity of 95.2%. Conclusion: Examination of E-selectin is of great value in diagnosis and differential diagnosis of benign or malignant pleural effusion. Co-examination of immunology, biochemistry and molecular biology could improve the diagnosis and accuracy in tuberculous pleurisy and cancerous pleural effusion. There is no meaning to diagnosis TB and cancerous pleural effusion only according to this standard.