늑막삼출액의 fibronectin 농도와 Adenosine Deaminase활성도의 암과 결핵에서의 감별진단적 의의

Abstract

The differential diagnosis of pleural effustioin remains to be solve. The aim of this study was to evaluate the diagnostic values of the fibronectin concentration and andevosine deaminase activity in the differentiation between tuberculous and malignant pleural effusion. The activity of adenosine deaminase and the concentration of fibronectin were investigated in pleural effusions from 10 patients with tuberculous pleurisy and 10 patients with malignant effusion. The mean ADA activity was significantly higher in the tuberculous pleurisy (74.01±24.05 U/L) than in the malignant pleural effusion(15.46±13.08 U/L). Based on the lowest value of ADA activity found in the tuberculous pleurisy (45 U/L), the test had a sensitivity of 1 and a specificity of 1. There was no difference between the fibronectin concentration of pleural fluid in the tuberculous pleurisy (306.62±50.52mg/ml) and in the malignant pleural effusion (250.50±144.28㎍/ml) By discriminant analysis, the ADA activity was good indicator for differentiation of tuberculous from malignant pleural effusion (% of correctly classified = 95%) and the simultaneous determinations of both parameters in not more efficient tn the differential diagnosis than in determination of only ADA activity. The present study showed that determination of ADA in pleural fluid is of great value in the differentiation between tuberculous pleurisy and malignant pleural effusion.