Measuring ADA、ACE、LDH and CEA Jointly for Differential Diagnosis between Tuberculous and Malignant Pleural Effusion

Objective To determine the differential diagnosis value of adenosine deaminase(ADA),Angiotensin converting enzymes(ACE),Lactate dehydrogenase(LDH) and carcinoembryonic antigen(CEA) measured jointly between tuberculous and malignant pleural effusion.Method There were 72 objects that consisted of 32 patients with malignant pleural effusion(malignant group),and 40 patients with tuberculous pleural effusion(tuberculous group)in the study.ADA,ACE,LDH were detected by terminal reaction of enzymology,while CEA was detected by chemiluninescence immunoassay.Result The ADA activity of tuberculous and malignant pleural effusion were(60.2±20.10)U/L and(11.02±5.23) U/L,respectively(P 0.01).The ACE activity of tuberculous and malignant pleural effusion were(35±9.6)U/L and(16±11.0) U/L,respectively(P 0.01).The CEA activity of tuberculous and malignant exudate were(12.8±5.82) μg/L and(39.9±19.7) μg/L,respectively(P 0.01).The specific values of ADA and ACE(pleural effusion/serum)in tuberculous pleural effusion were significantly higher than that in malignant pleural effusion(P 0.01),so did it of the concentration.However,the specific values of CEA(pleural effusion/serum) in malignant pleural effusion were significantly higher than that in tuberculous pleural effusion(P 0.01),so did it of the concentration.Furthermore,the sensitivity of ADA and ACE for tuberculosis diagnosis was 84.3% and 87.5%,respectively,while the specificity was 87.5% and 80.0%.The sensitivity of the LDH,CEA for malignant diagnosis was 84.3% and 75.0%,respectively,while the specificity was 80.0% and 93.0%.Finally,the sensitivity of measuring all these targets jointly was 78.1%,and the specificity was 97.5%,which was higher than that of anyone in these targets significantly.Conclusion The detection of ADA,ACE,LDH and CEA jointly in pleural effusion is of great value in differentiating tuberculous pleural effusion from malignant pleural effusion.