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液态芯片技术联合检测IFN-γ、IP-10诊断结核性胸腔积液

刘佳庆1,张立1,孙海柏1,吴敏1,杜岩青1,冯爽1,刘树业2   

  1. 1. 天津市海河医院
    2. 天津第三中心医院
  • 收稿日期:2013-12-16 修回日期:2014-04-25 出版日期:2014-09-15 发布日期:2014-09-15
  • 通讯作者: 刘佳庆

Diagnostic Value of Combined Detection of the Level of IFN-γ and IP-10 by Liquid Array

Jia-Qing LIU1,ZHANG Li 1,SUN Haibai 1,WU Min 1,DU Yanqing 1,FENG Shuang 1,LIU Shuye 2   

  1. 1. Tianjin Haihe Hospital, Tianjin 300350, China;
    2. The Third Central Clinical School of Tianjin Medical University△Corresponding Author E-mail:lshye@163.com
  • Received:2013-12-16 Revised:2014-04-25 Published:2014-09-15 Online:2014-09-15
  • Contact: Jia-Qing LIU

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摘要：

【摘要】目的 应用液态芯片技术联合检测胸腔积液中干扰素（IFN）-γ、IFN-γ诱导蛋白（IP）-10 水平，探讨其在临床快速诊断及鉴别诊断结核性胸腔积液中的应用价值。方法 选取渗透性胸腔积液患者，其中结核性胸腔积液组52 例；恶性胸腔积液组38 例。利用结核感染T 细胞斑点试验（T-SPOT.TB）测定其对结核杆菌反应的效应T 细胞数量，即斑点形成细胞数（SFCs），同时利用液态芯片技术测定其IFN-γ和IP-10 水平，通过Logistic 逐步回归法评估IFN-γ和IP-10 联合诊断时的价值，并比较两种诊断方法的价值。结果 T-SPOT.TB 法诊断结核性胸腔积液的灵敏度为90.38%，特异度为84.21%，ROC 曲线下面积（AUC）及95%CI 为0.938(0.867~0.978)；IFN-γ、IP-10 联合诊断结核性胸腔积液时的灵敏度为98.08%，特异度为97.37%，AUC 及95%CI 为0.995（0.951~1.000）。2 种诊断方法灵敏度和特异度的差异不明显；2 种方法诊断一致性良好（Kappa=0.703）；方法间AUC 比较差异有统计学意义（Z=1.996， P < 0.05），检测IFN-γ、IP-10 水平联合诊断时AUC 较大（AUC=0.995）。结论  利用液态芯片技术同时检测IFN-γ、 IP-10 水平联合诊断结核性胸腔积液满足了临床快速、准确诊断及鉴别诊断结核性胸腔积液的需要。

关键词: 干扰素Ⅱ型, 结核, 液态芯片, 趋化因子CXCL10, 胸腔积液, 恶性, ROC 曲线, 结核感染T 细胞斑点试验

Abstract:

[Abstract] Objective  To explore the diagnostic value of combined detection of the liquid array technology, interferon (IFN)-γ and IFN-γ-inducible protein (IP)-10 in the rapid, accurate diagnosis and differential diagnosis of tuberculous pleural effusions. Methods Patients with transudative pleural effusions were divided into tuberculous pleural effusion group (n=52) and malignant pleural effusion group (n=38). The method of T-SPOT.TB was used to detect the number of effee tor T cells sensitized to Mycobacterium tuberculosis and spot forming cells (SFCs). The liquid array technology was used to detect the level of IFN-γ and IP-10. Logistic regression was used to analyze and compare the diagnostic value of the twomethod combination. Results The diagnostic sensitivity, specificity and the area under the ROC curve (AUC) of T-SPOT. TB were 90.38%, 84.21%, and 0.938 (95%CI: 0.867-0.978), respectively. The diagnostic sensitivity, specificity and AUC of combined detection of IFN-γ and IP-10 were 98.08%, 97.37%, and 0.995 (95%CI: 0.951-1.000), respectively. There was no significant difference in the diagnostic sensitivity and specificity between the two methods, and the diagnostic agreement for the two diagnostic methods was fine (Kappa=0.703). The difference of AUC between the methods was significantly differ? ent (Z=1.996, P <0.05). The method of combined detection of IFN-γ and IP-10 showed the larger AUC (AUC= 0.995). Conclusion The combined diagnosis meets the clinical needs of rapid, accurate diagnosis and differential diagnosis for tuberculous pleural effusion by simultaneously assaying the level of IFN-γ and IP-10 using the liquid array technology.

Key words: interferon type Ⅱ, tuberculosis, liquid array technology, chemokine CXCL10, pleural effusion, malignant, ROC Curve, 结核感染T 细胞斑点试验