HUANG Yanchun , WU Lijuan , DING Liu , LU Xiaojun , LIU Tangyuheng , YING Binwu
  • Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
YING Binwu, Email: binwuying@126.com
Tuberculous pleural effusion; Malignant pleural effusion; Laboratory indexes; Diagnostic efficacy
10.7507/1002-0179.201807065
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ObjectiveTo analyze the clinical characteristics of patients with tuberculous pleural effusion and malignant pleural effusion and explore the value of laboratory indexes of pleural effusion in the differential diagnosis of tuberculous pleural effusion and malignant pleural effusion.MethodsThe clinical data and laboratory indexes of pleural effusion of patients with tuberculous pleural effusion and patients with malignant pleural effusion hospitalized in West China Hospital of Sichuan University between January and December 2017 were analyzed retrospectively. Those examinations with statistical significance were selected to establish a binary logistic regression model for diagnosing malignant pleural effusion from tuberculous pleural effusion. Hosmer-Lemeshow test was used to assess the goodness of fit of the logistic model, and a receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of the model.ResultsThe average age of the 128 patients with tuberculous pleural effusion was (51.60±21.02) years, and the average age of the 164 malignant pleural effusion was (63.52±11.87) years. Patients with tuberculous pleural effusion were prone to getting symptoms of cough, expectoration, fever, chest pain and tightness in breathing, with statistical significance (P<0.05). The level of adenosine deaminase in patients with tuberculous pleural effusion was (23.06±21.29) U/L, higher than that in malignant pleural effusion; the difference was statistically significant (P<0.05). The levels of albumin, glucose, carbohydrate antigen (CA) 125, CA19-9, carcinoembryonic antigen (CEA) and cyto-keratin 19 fragment antigen 21-1 in patients with malignant pleural effusion were higher than those in patients with tuberculous pleural effusion (P<0.05). Logistic regression analysis showed that CA125, CEA and glucose were introduced to model as the main effect. The area under the ROC curve was 0.914 [95% confidence interval (0.864, 0.964)], with an improved diagnostic efficiency.ConclusionsThe clinical manifestations of tuberculous pleural effusion and malignant pleural effusion are multifarious with low specificity. A joint detection of CA125, CEA and glucose in pleural effusion and the joint diagnostic model can identify tuberculous pleural effusion and malignant pleural effusion better.

Citation： HUANG Yanchun, WU Lijuan, DING Liu, LU Xiaojun, LIU Tangyuheng, YING Binwu. Diagnositic efficacy of clinical characteristics and laboratory indexes in tuberculous pleural effusion and malignant pleural effusion. West China Medical Journal, 2018, 33(8): 966-971. doi: 10.7507/1002-0179.201807065 Copy

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