广东医学2026，Vol.47Issue(1)：39-44,6.DOI:10.13820/j.cnki.gdyx.20251874
IFN-γ和IL-2联合检测在老年结核性胸膜炎与恶性胸腔积液鉴别诊断中的应用
Application of combined interferon-γ and interleukin-2 detection in the differential diagnosis of tuberculous pleural effusion and malignant pleural effusion in elderly patients
摘要
Abstract
Objective To investigate the diagnostic value of multiple inflammatory markers combined with Myco-bacterium tuberculosis-specific interferon-γ(IFN-γ)and interleukin-2(IL-2)dual-factor detection in differen-tiating tuberculous pleural effusion(TPE)from malignant pleural effusion(MPE)in elderly patients.Methods A ret-rospective analysis was conducted on 140 patients aged ≥60 years with pleural effusion admitted to Lanzhou Pulmonary Hospital from January 2023 to December 2024.Among them,80 cases were diagnosed as TPE and 60 as MPE.Laboratory parameters including Mycobacterium tuberculosis-specific IFN-γ and IL-2,erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP),serum lactate dehydrogenase(LDH),serum adenosine deaminase(ADA),and pleu-ral fluid LDH and ADA were collected and compared between the two groups.Diagnostic performance of each indicator and their combinations was evaluated by receiver operating characteristic(ROC)curve analysis.Results There was no significant difference in mean age between the TPE and MPE groups(P＞0.05),but the proportion of males was signifi-cantly higher in the TPE group(P＜0.05).Compared with the MPE group,TPE patients showed significantly higher lev-els of IFN-γ,IL-2,ESR,serum ADA,and pleural ADA(P＜0.05),while serum LDH was significantly lower(P＜0.05).No significant differences were found in serum CRP or pleural LDH(P＞0.05).Using IFN-γ≥7 pg/mL and/or IL-2 ≥20 pg/mL as diagnostic thresholds yielded a sensitivity of 82.5％,specificity of 85.0％,and overall accuracy of 83.6％.In MPE patients,dual IFN-γ and IL-2 positivity demonstrated the highest specificity(98.33％).The area under the curve(AUC)values for IFN-γ,IL-2,and combined dual-factor detection were 0.820,0.807,and 0.823,respectively.The dual-factor AUC was significantly higher than those of ESR(Z=2.094,P=0.036),serum LDH(Z=3.471,P=0.000),and serum ADA(Z=2.500,P=0.012),but not significantly different from pleural ADA(Z=0.535,P=0.592).Moreover,combining dual-factor detection with pleural ADA yielded an AUC of 0.897(95％CI:0.834-0.942),significantly higher than either test alone(Z=2.056,P=0.040;Z=3.082,P=0.002,respectively).Conclusion Combined detection of Mycobacterium tuberculosis-specific IFN-γ and IL-2 provides valuable diagnostic information for differentiating tuberculous pleural effusion from malignant pleural effusion in elderly pa-tients.Dual positivity(IFN-γ/IL-2)offers the highest specificity,and the addition of pleural ADA measurement fur-ther enhances diagnostic accuracy.关键词
结核性胸膜炎/恶性胸腔积液/炎症指标/双因子联合检测/鉴别诊断Key words
tuberculous pleural effusion/malignant pleural effusion/inflammatory markers/dual-factor detec-tion/differential diagnosis分类
医药卫生引用本文复制引用
张鑫,邢惟俊,杨增伟,姚文,徐芳,同重湘..IFN-γ和IL-2联合检测在老年结核性胸膜炎与恶性胸腔积液鉴别诊断中的应用[J].广东医学,2026,47(1):39-44,6.基金项目
国家重点研发专项(2023YFC2307200-2023YFC2307201) （2023YFC2307200-2023YFC2307201）
兰州市科技发展指导性计划项目(2024-9-212) （2024-9-212）
兰州市科技发展计划项目(2023-ZD-155) （2023-ZD-155）
