Diagnostic value of serous effusion cell morphology and count combined with adenosine deaminase test in tuberculous serous membrane inflammation

doi:10.3877/cma.j.issn.1674-0785.2020.01.003

Abstract

Abstract:

Objective

To explore the diagnostic value of serous effusion cell morphology and count combined with adenosine deaminase (ADA) test for tuberculous serous membrane inflammation, and evaluate its application by receiver operating characteristic (ROC) curve analysis and Logistic regression.

Methods

A retrospective analysis was performed on 328 clinical cases (including 177 cases in the tuberculosis group and 151 cases in the non-tuberculosis group) from June 2018 to June 2019. All standard cytology and ADA tests were performed, Logistic regression model was established, and ROC curve was plotted to evaluate its predictive efficacy.

Results

Indicators that were eventually incorporated into the model included the number of nucleated cells (×10⁶/L), lymphocyte percentage (%), the number of lymphocytes (×10⁶/L), mesothelial cell percentage (%), mesothelial cell number (×10⁶/L), ADA (mg/L), abnormal lymphocytes or lymphoid cells, and nuclear heterogeneous mesothelial cells. Logistic regression analysis showed that the area under the ROC curve of combined detection was 0.971 [95% CI (0.955-0.986)], and the sensitivity and specificity were 90.0% and 94.0%, respectively, all of which were higher than those of single detection.

Conclusion

Cell morphology combined with ADA detection can predict tuberculous serous membrane inflammation with high accuracy and clinical practicability.

Key words: Tuberculous serous membrane inflammation, Cytology, Adenosine deaminase, Logistic models

Yuanyuan Du, Mao Wu, Peng Li, Huijun Lin, Nina Wu. Diagnostic value of serous effusion cell morphology and count combined with adenosine deaminase test in tuberculous serous membrane inflammation[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(01): 13-17.

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References 21

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组别	例数	有核细胞数量（×10⁶/L）	淋巴细胞比例（%）	淋巴细胞数量（×10⁶/L）	间皮细胞比例（%）	间皮细胞数量（×10⁶/L）
结核组	177	1874.6±691.5	72.8±22.6	1330.0±243.6	3.4±4.7	66.8±26.6
非结核组	151	921.3±910.0	23.1±18.4	200.3±318.3	19.3±21.1	110.9±85.1
t值	?	22.30	441.60	112.40	92.70	6.10
P值	?	<0.01	<0.01	<0.01	<0.01	0.014

组别	例数	有核细胞数量（×10⁶/L）	淋巴细胞比例（%）	淋巴细胞数量（×10⁶/L）	间皮细胞比例（%）	间皮细胞数量（×10⁶/L）
结核组	177	1874.6±691.5	72.8±22.6	1330.0±243.6	3.4±4.7	66.8±26.6
非结核组	151	921.3±910.0	23.1±18.4	200.3±318.3	19.3±21.1	110.9±85.1
t值	?	22.30	441.60	112.40	92.70	6.10
P值	?	<0.01	<0.01	<0.01	<0.01	0.014

组别	例数	李凡他试验阳性［例（%）］	异型淋巴细胞/淋巴母细胞［例（%）］	核异质间皮细胞［例（%）］	干酪样/坏死颗粒［例（%）］	ADA（mg/L）
结核组	177	169（95.48）	105（59.32）	61（34.46）	5（2.82）	47.2±26.1
非结核组	151	88（58.27）	9（5.96）	75（49.67）	3（1.98）	8.3±7.1
统计值	?	χ²=66.30	χ²=102.30	χ²=7.80	χ²=0.20	t=322.1
P值	?	<0.01	<0.01	0.007	0.71	<0.01

组别	例数	李凡他试验阳性［例（%）］	异型淋巴细胞/淋巴母细胞［例（%）］	核异质间皮细胞［例（%）］	干酪样/坏死颗粒［例（%）］	ADA（mg/L）
结核组	177	169（95.48）	105（59.32）	61（34.46）	5（2.82）	47.2±26.1
非结核组	151	88（58.27）	9（5.96）	75（49.67）	3（1.98）	8.3±7.1
统计值	?	χ²=66.30	χ²=102.30	χ²=7.80	χ²=0.20	t=322.1
P值	?	<0.01	<0.01	0.007	0.71	<0.01

项目	敏感度（%）	特异度（%）	阳性似然比	阴性似然比	阳性预测值（%）	阴性预测值（%）
有核细胞数量（≥690×10⁶/L）	74.6	70.3	2.5	0.4	74.2	70.8
淋巴细胞比例（≥46%）	85.3	86.5	6.3	0.2	87.8	83.8
淋巴细胞数量（≥340×10⁶/L）	81.9	79.4	4.0	0.2	81.9	79.4
间皮细胞比例（≤5.5%）	84.7	67.7	2.6	0.2	75.0	79.5
间皮细胞数量（≤20.7×10⁶/L）	42.2	69.7	1.4	0.8	62.7	50.0
李凡他试验阳性	85.5	43.2	1.7	0.1	65.8	89.3
有异型淋巴细胞/淋巴母细胞	59.3	94.2	10.2	0.4	92.1	67.0
有核异质间皮细胞	36.5	51.6	0.8	1.2	44.9	43.0
ADA水平（≥23.35 mg/L）	86.8	89.2	15.5	0.1	90.6	86.0

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