Identification and diagnostic value of pleural fluid periostin and serum periostin of malignant pleural effusions in patients with non-small cell lung cancer
【摘要】：Background: Data on the diagnostic value of combined detection of pleural fluid periostin(pPOSTN), serum periostin(sPOSTN), pleural effusion carbohydrate antigen 199(pCA199) and pleural effusion adenosine deaminase(pADA) in differentiating malignant pleural effusion(MPE) caused by non-small cell lung cancer(NSCLC) are limited.Methods: We collected 84 pleural effusion samples which including 44 cases of MPE caused by NSCLC and 40 cases of benign pleural effusions(BPE) from August 2018 to January 2019. The pPOSTN, sPOSTN, pleural fluid lactate dehydrogenase(pLDH), pADA, pleural effusion total protein(pTP), pleural fluid glucose(pGLU), pleural effusion leucocyte count(pWBC), pleural effusion red cell count(pRBC), pCA199, pleural fluid carbohydrate antigen 125(pCA125), pleural effusion ferritin(pFer), serum total protein(sTP), serum C-reactive protein(sCRP) were tested, and the obtained data were analyzed by statistical software.Results: The level of pPOSTN in the MPE group was observably lower than the BPE group(Mann-Whitney U=476.000, P=0.000); the level of sPOSTN in the MPE group was observably higher than the BPE group(MannWhitney U=565.500, P=0.005); the sPOSTN/pADA, pCA199/pADA and pCA199/pPOSTN levels in the MPE group were observably higher than the BPE group(Mann-Whitney U=265.000, 259.000 and 282.000, P=0.000, 0.000 and 0.000). The receiver operating characteristic(ROC) curve showed that the area under the ROC curve(AUC)(=0.844, 0.847, 0.841) of sPOSTN/pADA, pCA199/pADA and pCA199/pPOSTN(cutoff=11.86, 0.244, 0.015) were observably higher than other indicators for the diagnosis of MPE caused by NSCLC. Thus, combined detection of pPOSTN, pCA125/pPOSTN and pCA125/sCRP suggested that the AUC, sensitivity and specificity, was 0.912, 95.45% and 77.50% at the cutoff 0.317 and diagnostic performance was higher than sPOSTN/pADA or pCA199/pADA or pCA199/pPOSTN.Conclusion: Combined detection of sPOSTN/pADA, pCA199/pADA and pCA199/pPOSTN can be used a very important index for differentiating MPE caused by NSCLC from BPE with higher diagnostic value than sPOSTN/pADA or pCA199/pADA or pCA199/pPOSTN.