Objective. The aim of the study is to investigate the clinical value of matrix metalloproteinases-3 (MMP-3) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) combined with adenosine deaminase (ADA) in pleural effusion and serum in benign and malignant pleural exudative effusion (PEE). Methods. A total of 119 adult patients with PEE admitted in our hospital from May 2018 to October 2021 were selected. According to the patient’s condition, the patients were divided into the benign group (n = 75) and the malignant group (n = 44). The levels of MMP-3, CYFRA21-1, and ADA in pleural effusion and serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the individual and combined predictive value of MMP-3, CYFRA21-1, and ADA levels. Results. In the malignant group, the pleural effusion and serum MMP-3 and CYFRA21-1 levels were higher than those in the benign group and the ADA levels were lower than those in the benign group (P < 0.05). In the malignant group, the positive detection rate of pleural effusion and serum MMP-3 and CYFRA21-1 was higher than that in the benign group and the positive detection rate of pleural effusion and serum ADA were lower than that in the benign group (P < 0.05). The AUC of pleural effusion MMP-3, serum MMP-3 and the combination of them in the diagnosis of PEE were 0.764, 0.722 and 0.810, respectively. The AUC of pleural effusion CYFRA21-1 and serum CYFRA21-1 and combination of them in the diagnosis of PEE were 0.776, 0.748 and 0.822, respectively. The AUC of pleural effusion ADA, serum ADA and their combination in differential diagnosis of PEE were 0.762, 0.737 and 0.836, respectively. The AUC of pleural effusion and serum of MMP-3 and CYFRA21-1 combined with ADA for differential diagnosis of PEE was 0.923. Conclusions. The diagnostic efficacy of MMP-3 combined with CYFRA21-1 and ADA in pleural effusion and serum for benign and malignant PEE are better than single index, which has certain clinical values for the selection of early intervention scheme for PEE patients.

中文翻译：

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胸腔积液及血清MMP-3、CYFRA21-1联合ADA鉴别诊断胸腔积液的临床价值


客观的。本研究旨在探讨基质金属蛋白酶-3（MMP-3）和细胞角蛋白19片段抗原21-1（CYFRA21-1）联合腺苷脱氨酶（ADA）在良恶性胸腔积液和血清中的临床价值。胸腔渗出液（PEE）。方法。共选取2018年5月至2021年10月我院收治的119例成人PEE患者。根据患者病情，将患者分为良性组（ n =75）和恶性组（ n =44）。检测胸腔积液和血清中MMP-3、CYFRA21-1、ADA的含量。使用受试者工作特征（ROC）曲线分析MMP-3、CYFRA21-1和ADA水平的单独和组合预测价值。结果。恶性组胸腔积液及血清中 MMP-3、CYFRA21-1 的含量高于良性组，ADA 的含量低于良性组（ P < 0.05）。恶性组胸腔积液、血清MMP-3、CYFRA21-1阳性检出率高于良性组,胸腔积液、血清ADA阳性检出率低于良性组( P < 0.05）。胸腔积液MMP-3、血清MMP-3及其联合诊断PEE的AUC分别为0.764、0.722和0.810。胸腔积液CYFRA21-1和血清CYFRA21-1及其联合诊断PEE的AUC分别为0.776、0.748和0.822。胸腔积液ADA、血清ADA及其联合鉴别诊断PEE的AUC分别为0.762、0.737和0.836。 胸腔积液和血清中MMP-3和CYFRA21-1联合ADA鉴别诊断PEE的AUC为0.923。结论。 MMP-3联合CYFRA21-1和ADA在胸腔积液和血清中对良恶性PEE的诊断效能均优于单一指标，对于PEE患者早期干预方案的选择具有一定的临床价值。