在结核病和血液恶性瘤之间进行区分的特征是高氨酸脱氨酶的多发性液的原因
Junsu Choe1, Sun Hye Shin1, Kyeongman Jeon1
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
Respiratory research
|January 4, 2024
概括
胸腔液中的高腺脱氨酶 (ADA) 可以表明结核性胸腔炎 (TBP) 或血液性恶性胸腔溢出 (hMPE). 特定的ADA水平和其他标记物有助于区分这些疾病,改善诊断.
科学领域:
- 肺部医学 肺部医学
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 腺脱氨酶 (ADA) 是结核性肺炎 (TBP) 的生物标志物.
- 高水平的ADA也可能存在于血液性恶性多叶流血 (hMPE).
- 在ADA升高的患者中,区分TBP与hMPE在临床上很重要.
研究的目的:
- 为了确定特征区分TBP从hMPE在患有多叶流血的患者的ADA≥40IU/L.
- 分析ADA水平和其他临床参数与TBP和hMPE的相关性.
主要方法:
- 追溯观察性研究1134名患者的肺溢 ADA≥40IU/L.
- 多变量逻辑回归分析以确定区分特征.
- 对多液ADA水平,细胞计数,乳酸脱酶 (LD) /ADA比率和血清标记物的分析.
主要成果:
- TBP和hMPE分别在33.1%和7.5%的患者中被诊断出.
- 70-150 IU/L之间的ADA水平与TBP相关,而ADA≥150 IU/L与hMPE相关.
- 关键的区分特征包括淋巴细胞百分比,LD/ADA比率,多多态核中性粒细胞和血清LD水平.
- 淋巴细胞≥35%,LD/ADA<18和ADA<150IU/L的组合预测了TBP,敏感度为82.4%,特异性为93.7%.
结论:
- 在患有非常高的多ADA水平的患者中,应考虑血液恶性多溢出 (hMPE).
- 特定的多液和血清标记物可以帮助区分TBP与hMPE.
- 精确的区分可以改善多流的诊断和治疗策略.
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