ObjectiveTo investigated the levels of aldolase A (ALDOA) in pleural effusion in patients with different pathological types of lung cancer and patients with tuberculous pleurisy,and the correlation between ALDOA and carcinoembryonic antigen (CEA),lactate dehydrogenase(LDH). Methods80 cases of pleural effusion samples were collected,of which 65 cases of lung cancer (malignant group) and 15 cases of tuberculous pleurisy (TB group). All the patients were not treated with anti-inflammatory or steroid therapy. ALDOA concentrations in pleural effusion were detected by ELISA and the contents of CEA and LDH in pleural fluid were detected by chemiluminescence assay. ResultsThe levels of ALDOA,CEA and LDH in the malignant group were 46.75±21.39 ng/mL,82.24±56.63 ng/mL,755.76±382.54 U/L respectively,and were 23.92±17.21 ng/mL,2.55±1.67 ng/mL,and 388.37±163.87 U/L in the TB group respectively. The levels of ALDOA,CEA and LDH in the malignant group were significantly higher than those in the TB group (P<0.01). The concentrations of ALDOA in malignant pleural effusion from different pathological types of lung cancer were 71.65±32.09 ng/mL(adenocarcinoma),22.43±18.23 ng/mL(small cell lung cancer),and 19.16±13.85 ng/mL(squamous cell carcinoma),respectively. The concentration of ALDOA in malignant pleural effusion from the adenocarcinoma patients was significantly higher than that in the other two types (P<0.05). The concentration of CEA was 112.40±62.71 ng/mL(adenocarcinoma),62.45±54.78 ng/mL(small cell lung cancer),and 71.87±52.4 ng/mL(squamous cell carcinoma),respectively. It was significantly higher in adenocarcinoma than that in other two types (P<0.05). The levels of LDH were 661.81±328.93 U/L(adenocarcinoma),737.62±315.41 U/L(small cell lung cancer),767.85±503.28 U/L(squamous cell carcinoma),respectively. There was no significant difference in three types(P>0.05). The concentrations of ALDOA in pleural effusion from the patients with lung cancer or tuberculous pleurisy were positively correlated with the concentrations of CEA and LDH (P<0.01 or 0.05). ConclusionThe levels of ALDOA,CEA and LDH in malignant pleural effusion from lung cancer patients were significantly higher than those in pleural effusion from patients with tuberculous pleurisy. The ALDOA and CEA levels in malignant pleural effusion from lung adenocarcinoma patients were significantly higher than those in small cell lung cancer and squamous cell carcinoma patients. There were highly positive correlation between ALDOA,CEA and LDH levels.
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.