摘要
目的探讨T细胞酶联免疫斑点(TSPOT-TB)法在诊断肺癌合并肺结核中的应用。方法选取2016年2月至2018年4月间上海复旦大学附属中山医院青浦分院收治的226例肺部疾病患者,包括138例单纯肺结核患者、54例单纯肺癌患者和34例肺癌合并肺结核患者。三组患者使用TSPOT-TB、结核菌素纯蛋白生物(PPD)实验、结核抗体和鳞状细胞癌抗原(SCC)检测后,比较不同检测方法阳性率。结果结核组TSPOT-TB阳性率84.8%,肺癌组1.9%,肺癌合并结核组85.3%,结核组与合并组比较,差异无统计学意义(P>0.05),两组均高于肺癌组,差异均有统计学意义(均P<0.05)。PPD结果分析发现,结核组PPD阳性率93.5%,肺癌组46.3%,肺癌合并结核组88.2%,结核组与合并组比较,差异无统计学意义(P>0.05),两组均高于肺癌组,差异均有统计学意义(均P<0.05)。结核抗体结果分析发现,结核组结核抗体阳性率67.4%,肺癌组37.0%,肺癌合并结核组67.6%,结核组与合并组比较,差异无统计学意义(P>0.05),两组均高于肺癌组,差异均有统计学意义(均P<0.05)。SCC结果分析发现,结核组SCC阳性率0.0%,肺癌组27.8%,肺癌合并结核组29.4%,肺癌组与合并组比较,差异无统计学意义(P>0.05),两组均高于结核组,差异均有统计学意义(均P<0.05)。结论TSPOT-TB能有效鉴别肺癌与肺结核,与肿瘤标志物联合检测时,鉴别肺癌合并肺结核和单纯肺结核均有较高的灵敏性和特异性。
Objective To study the application of T-cell enzyme-linked immunospot assay in the diagnosis of lung cancer complicated with pulmonary tuberculosis,and to analyze its effectiveness.Methods A total of 226 patients including 138 patients with single tuberculosis,54 patients with single lung cancer and 34 patinets with lung cancer complicate with tuberculosis who admitted to Shanghai Fudan University Affiliated Zhongshan Hospital Qingpu Branch were enrolled from February 2016 to April 2018.The positive rate was compared among the three groups after T cell enzyme-linked immunospot assay(TSPOT-TB),purified protein derivative(PPD),antibody and squamous cell carcinomaantigen(SCC)detection were performed.Results The positive rate for TSPOT-TB was 84.8%in tuberculosis group,1.9%in lung cancer group and 85.3%in lung cancer complicate with tuberculosis group.There was no significant difference between the tuberculosis group and lung cancer complicate with tuberculosis group(P>0.05)but the positive rate for TSPOT-TB was higher in these two groups than in lung cancer group(all P<0.05).The positive rate for PPD was 93.5%,46.3%and 88.2%,respectively in tuberculosis group,lung cancer group and lung cancer complicated with tuberculosis group.There was no significant difference between the tuberculosis group and lung cancer complicate with tuberculosis group(P>0.05)but the positive rate for PPD was higher in these two groups than in lung cancer group(all P<0.05).The positive rate for tuberculosis antibody was 67.4%,37.0%and 67.6%,respectively in tuberculosis group,lung cancer group and lung cancer complicated with tuberculosis group.There was no significant difference between the tuberculosis group and lung cancer complicate with tuberculosis group(P>0.05)but the positive rate for tuberculosis antibody was higher in these two groups than in lung cancer group(all P<0.05).The result of detection of SCC showed positive rate was 0.0%,27.8%and 29.4%respectively in tuberculosis group,lung cancer group and lung cancer complicated with tuberculosis group.There was no significant difference between the tuberculosis group and lung cancer complicate with tuberculosis group(P>0.05)but the positive rate for SCC was higher in these two groups than in lung cancer group(all P<0.05).Conclusion TSPOT-TB can effectively identify tuberculosis,lung cancerand lung cancer complicate with tuberculosis with high sensitivity and specificity.
作者
陆群
金婷
LU Qun;JIN Ting(Department of Infectious Disease,Shanghai Fudan University Affiliated Zhongshan Hospital Qingpu Branch,Shanghai 201700,China)
出处
《中国肿瘤临床与康复》
2019年第10期1177-1180,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
T细胞酶联免疫斑点法
肺肿瘤
肺结核
有效性
T cell enzyme-linked immunospot assay
Lung neoplasms
Tuberculosis
Effectiveness
