血管内皮生长因子、基质金属蛋白酶-2对良恶性胸腔积液的诊断价值

摘要

目的 探讨胸腔积液中血管内皮生长因子(VEGF)和基质金属蛋白酶-2(MMP-2)水平对恶性胸腔积液及结核性胸腔积液(良性)的鉴别诊断价值.方法 采用ELISA法,检测40例恶性胸腔积液、40例结核性胸腔积液病人胸腔积液中VEGF和MMP-2表达水平,并进行比较.结果 恶性胸腔积液组VEGF和MMP-2水平均明显高于结核性胸腔积液组,差异有显著性(P<0.01).良恶性胸腔积液中VEGF和MMP-2表达水平呈正相关.VEGF和MMP-2联合检测可提高敏感性和特异性,分别为:86.5%、95.6%.若VEGF、MMP-2和CEA联合检测其敏感性和特异性分别为:92.1%、100%.结论 联合检测胸腔积液VEGF和MMP-2对鉴别结核性和恶性胸腔积液具有重要的临床价值.%Objective To investigate the value of vascular endothelial growth factor ( VEGF ) and matrix metalloproteinase-2 ( MMP-2 ) in differentiating tuberculous from malignant pleural effusion. Methods Using ELISA, the levels of VEGF and MMP-2 in pleu-ral effusion in 40 patients with tuberculous pleural effusion and 40 with malignant pleural effusion were detected and compared. Results The VEGF and MMP-2 levels in malignant pleural fluid were markedly higher than those in tuberculous pleural fluid, with a significant difference between them( P <0. 01 ). The expression of VEGF was correlated significantly positive with the expression MMP-2 in pleural fluid( r =0. 832,P <0. 01 ). The sensitivity and specificity of combined detection of VEGF and MMP-2 increased to 86. 5% and 95. 6% , respectively. Moreover, for VEGF, MMP-2 and CEA, the sensitivity and specificity combined detection increased to 92. 1% and 100% , respectively. Conclusion Combined detection of VEGF and MMP-2 in pleural effusion is of great clinical significance in differentiating tu-berculous from malignant pleural effusion.