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目的探讨apoE在鉴别肺疾病良恶性胸水的价值。方法收集2011年4月-2012年2月温州医学院附属第一医院肺部疾病患者的恶性胸水标本160例,良性胸水标本40例。采用ELISA方法检测apoE蛋白水平,化学发光法检测肿瘤标志物,结合临床资料对各组进行统计学分析。结果 MPE的apoE水平明显高于良性胸水;肺腺癌胸水apoE水平明显高于肺鳞癌和大细胞癌胸水。ROC曲线表明apoE在Cutoff值为105 ng/ml时,诊断MPE的敏感性和特异性分别为87.5%和85.3%,曲线下面积(AUC)为0.748。对于诊断肺腺癌MPE,apoE的敏感性和特异性分别为70.8%和83.3%,AUC为0.856在所有标志物中最高。结论非小细胞肺癌胸水apoE水平明显升高;胸水apoE可能是一个用于诊断非小细胞肺癌MPE的潜在肿瘤标志物。
Objective To investigate the value of apoE in the differential diagnosis of benign and malignant pleural effusion of lung disease. Methods 160 patients with malignant pleural effusion and 40 benign pleural effusion were collected from April 2011 to February 2012 in the First Affiliated Hospital of Wenzhou Medical College. The level of apoE protein was detected by ELISA, the tumor markers were detected by chemiluminescence, and the clinical data were used for statistical analysis. Results The apoE level of MPE was significantly higher than that of benign pleural effusion. The apoE level of pleural effusion of lung adenocarcinoma was significantly higher than that of lung squamous cell carcinoma and large cell carcinoma pleural effusion. The ROC curve showed that the sensitivity and specificity of apoE for the diagnosis of MPE at a cutoff value of 105 ng / ml were 87.5% and 85.3%, respectively, and the area under the curve (AUC) was 0.748. For the diagnosis of lung adenocarcinoma MPE, the sensitivity and specificity of apoE were 70.8% and 83.3%, respectively, and the AUC of 0.856 was the highest among all markers. Conclusions The apoE level of pleural effusion in non-small cell lung cancer is significantly increased. ApoE in pleural effusion may be a potential tumor marker for the diagnosis of MPE in non-small cell lung cancer.