【摘要】 目的评价癌胚抗原(CEA)、腺苷脱氨酶(ADA)水平及间皮细胞计数检测在恶性与结核性胸腔积液的鉴别诊断中的价值。方法收集2007年7月—2008年7月91例不明原因胸腔积液患者,并经胸腔镜病理组织活检确诊为结核性胸膜炎43例(结核性组)和恶性胸腔积液48例(恶性组),检测两组患者胸腔积液中CEA、ADA水平及间皮细胞计数。结果恶性胸腔积液组CEA、ADA、间皮细胞计数以及胸腔积液CEA/血清CEA比值与结核性组比较,差异均有统计学意义(P<0.05)。ADA诊断结核性胸腔积液的灵敏度为88.4%、特异度为95.0%、正确率为84.4%。CEA+ADA、CEA+间皮细胞正确率与间皮细胞+胸腔积液CEA/血清CEA比较,差异均有统计学意义(P<0.05)。结论联合检测CEA、ADA、间皮细胞计数、胸腔积液CEA/血清CEA比值,对鉴别恶性与结核性胸腔积液有较高的临床价值,所有联合检测中以CEA+ADA的诊断正确率最高。更多还原

【Abstract】 Objective To evaluate the value of carcinoembryonic antigen(CEA),adenosine deaminase(ADA) and mesothelial cell counting in differentiating between malignant pleural effusion(MPE) and tuberculous.Methods We chose 91 pleural effusion patients for unknown reasons from July 2007 to July 2008,among whom 43 were diagnosed as tuberculous pleurisy(group A) and 48 as MPE(group B) by thoracoscope pathological biopsy.The levels of CEA,ADA and mesothelial counting were determined in both groups.Results The levels of CEA,mesothelial cell counting and the ratio of CEA in pleural effusion and blood serum were significantly higher in group B than in group A.The sensitivity,specificity and correct rate of ADA level in tuberculous pleural effusion were 88.4%,95.0%,84.4%,respectively.The sensitivity and specificity of CEA+ADA and the CEA ratio in pleural fluid and blood serum were better in group B.Conclusion Combined detection of CEA,ADA,mesothelial cell counting,CEA ratio in pleural effusion or in blood serum is of relatively high clinical value in differentiating between MPE and tuberculous.The correct rate of CEA plus ADA is the highest in all indexes.更多还原