The identification diagnostic value of ADA,LDH,CEA,CA125,NSE and ferritin in tuberculous pleurisy and malignant pleural effusion

YUAN Meirong; LIU Qunqun

Abstract：Objective:To investigate the diagnosis value of pleural fluid adenosine deaminase(ADA),lactate dehydrogen-ase(LDH),carcinoembryonic antigen(CEA),carbohydrate antigen(CA125),ferritin and neuron - specific enolase(NSE)in tuberculous pleurisy and malignant pleural effusion. Methods:The level,positive rate,sensitivity and specificity of ADA,LDH, CEA,ferritin,NSE and CA125 were inspected from 72 patients in pleural effusion including 36 patients with tuberculous pleu-ral effusion(named as tuberculous group)and 36 patients with malignant pleural effusion(named as malignant group). The sta-tistical results were analyzed and compared. Results:The levels of ADA and LDH of tuberculous group were higher than the ones of malignant group,and can be used for differential diagnosis. The positive rates of ADA,LDH and ferritin of tuberculous group(32% ,24% and 32% )were higher than the ones of malignant group(24% ,10% and 22% ). In contrast,the positive rates of CEA(25% )from malignant group was higher than the one(0% )of tuberculous group. These positive rates can be ap-plied for differential diagnosis. For the two groups,the levels of CA125 in two groups were all higher that 35 U/ mL and not val-uable for differential diagnosis. The sensitivity level of ADA and ferritin with tuberculous pleurisy sensitivity 88. 89% ,and the specificity were similar(33. 33% and 38. 89% respectively). Although the sensitivity of CEA towards malignant pleural effu-sionwas only 6 9 . 4 4 % ,however its specificity reached 1 0 0 % . The sensitivity and specificity of LDH were 6 6 . 6 7 % and 72. 22% respectively,and had not significant for the differential diagnosis of tuberculous pleurisy and malignant pleural effu-sion. The specificity of CA125 was 0 and thus cannot be used for differential diagnosis. The sensitivity of NSE was low(only 30. 56% )and therefore not suitable for differential diagnosis. Conclusion:The levels of CEA were significant factors for the dif-ferential diagnosis of tuberculous pleurisy and malignant pleural effusion. The results of ADA can be used as one of the factors for the differential diagnosis of tuberculous pleurisy and malignant pleural effusion together with the level of LDH and CA125. The results of ferritin and NSE had no significant impact for the differential diagnosis of tuberculous pleurisy and malignant pleural effusion.