| Objective:Retrospective analysis on clinical manifestation and laboratory test results of tuberculous pleural effusion (TBPE) and malignant pleural effusion(MPE), compare the feature of TBPE and MPE, to actively analyse the value of joint examining carcinoembryonic antigen (CEA), lactate dehydrogenase(LDH) and adenosine deaminase (ADA) in differential diagnosing TBPE and MPE, combine clinical data.Method:Data of hospitalization patients with TBPE or MPE in the first affiliated hospital of Jinan University from January 1,2006 to December 31,2009 were analyzed retrospectively, including onset age, past history, clinical manifestation, laboratory data, imageology data, particularly the content of CEA, LDH and ADA. These data were compared by statistics means for getting a better understanding of TBPE and MPE and improving the ability of differential diagnosis.Results:1. TB group average (34.61±14.88) years of age and malignant group (58.05±16.10). with younger than 50 years of age to determine tuberculous pleural effusion, whose sensitivity was 82.50%, specificity of 76.92%, accuracy of 80.67%.2. The most common clinical manifestation of TB group was cough (80.00%), fever (76.25%), chest pain (75.00%), and malignant group was cough (74.36%) and anhelation (53.85%); With fever to determine tuberculous pleural effusion, whose sensitivity was 76.25% and specificity of 92.31%; With chest pain to determine tuberculous pleural effusion, whose sensitivity was 75.00% and specificity of 84.62%.3. X-ray and CT examination can be clear whether pneumonia, tuberculosis lesions, and malignant lesions, provide an important basis on diagnosis and differential diagnosis of pleural effusion; compared to X-ray examination (52.86%), CT(87.14%)positive rate was higher.4. The positive rate were all low:sputum etiology (1.89%), pleural effusion etiology (1.05%) in TB group and sputum cytology (0.00%), pleural effusion cytology (37.50%) in malignant group.5. The positive rate of TB-Ab-IgG was 5.41%, PPD test was 78.21% in TB group.6. The content of Tuberculous pleural effusion CEA was (1.55±1.40) ug/L and serum CEA were (1.67±1.02)ug/L, malignant group were (392.27±550.21)ug/L and (70.19±165.23) ug/L; The pLDH levels and the pLDH/sLDH ratio were no significant difference in two groups (p>0.05); The pADA levels were (39.72±13.26) u/L and (12.09±6.82) u/L, and the sADA levels were (12.25±3.55) u/L and (8.41±4.20)u/L, and the pADA/sADA ratios were (3.44±1.38) and (1.57±0.87). Their differences were statistically significant(3 p values were all equal to 0.000).Conclusion:1. The content of pADA and sADA were important basis for different diagnosing TBPE and MPE. The content of pADA is adout 40 u/L, which is lower than 45u/L, that as diagnostic standard is generally adopted; Regarding pADA/sADA=1 as a liability standard, TBPE is greater than 1, MPE is fewer than 1, which is still need more discussion and the virtual pADA/sADA= (3.44±1.38); But the ratio is bigger and more beneficial to TBPE.2. The logistic regression analysis shows putting onset age, fever, color of pleural effussion, ratio of pADA/sAD A together into using different diagnosis of TBPE and MPE has superior correctness.
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