Value of Combined Detection of Interferon-γ,Vascular Endothelial Growth Factor,C-reactive Protein and Adenosine Deaminase in Differential Diagnosis of Tuberculous and Malignant Pleural Effusion

Objective To explore the value of interferonⅡ,vascular endothelial growth factor,C-reactive protein and adenosine deaminase in differential diagnosis of tuberculous and malignant pleural effusion.Methods 122 cases with tuberculous pleurisy,56 cases of malignant pleural effusion,48 cases of tuberculous pleural effusion,18 cases of inflammatory and other pleural fluid were studied.The serum and pleural fluid levels of IFN-γ,VEGF-C,CRP and ADA serum in those patients were detected.Results The IFN-γ,CRP and ADA levels in tuberculous pleural effusion were higher than in malignant pleural effusion(P0.01).According to the receiver operator characteristic(ROC) curve,when 100ng/L was regarded as critical value of IFN-γ,the sensitivity and specificity of IFN-γ in diagnosing tuberculous pleural effusion were 83.1% and 92.3% respectively.When 45U/L ADA was regarded as critical value of ADA,the sensitivity and specificity of ADA in diagnosing tuberculous pleural effusion were 85.6% and 96.3% respectively.When 110mg/L was regarded as critical value of CRP,the sensitivity and specificity of CRP were 79.1% and 84.2% respectively.When combine detection of three markers,the diagnosis sensitivity and specificity were 87.8% and 86.0% respectively.The VEGF-C concentration in malignant pleural effusion was higher than that in tuberculous pleural effusion and inflammatory and other pleural effusion(P0.01).When the ratio of VEGF-C to ADA≥8,the sensitivity and specificity in diagnosis of malignant pleural effusion were 86.3% and 82.6% respectively,and the ration VEGF-C to ADA≤3,the sensitivity and specificity in diagnosis of tuberculous pleural effusion were 85.1% and 87.1% respectively.Conclusion The combined detection of IFN-γ,CRP and ADA could improve sensitivity and specificity in diagnosing tuberculous pleurisy.The concentration ratios of VEGF-C to ADA have clinical value in differential diagnosis of pleural effusions.