【摘要】 目的探讨检测胸水中肿瘤坏死因子(TNF-α)、癌胚抗原(CEA)和神经元特异性烯醇化酶(NSE)对胸腔积液的诊断价值。方法采用电化学发光酶免疫分析法检测59例结核性胸水和48例肺癌性胸水患者胸水中TNF-α、CEA和NSE水平。结果结核性胸水中TNF-α水平显著高于肺癌性胸水(P<0.05)。肺癌性胸水中CEA和NSE明显高于结核性胸水(P<0.01)。肺腺癌胸水中CEA升高最明显,非小细胞肺癌胸水中NSE升高最显著。联合检测CEA及NSE,诊断敏感度92.0%,准确度86.3%。结论检测TNF-α、CEA和NSE对结核性胸水和肺癌性胸水的诊断及鉴别诊断有较高的临床价值,联合检测胸水CEA和NSE可提高肺癌诊断敏感度。更多还原

【Abstract】 Objective To investigate the diagnostic value of tumor necrosis factor(TNF-α),carcinoembryonic antigen(CEA) and neuron-specific enolase(NSE) in pleural effusions.Methods TNF-α,CEA and NSE in pleural effusions were measured by electrochemiluminescence from 59 patients with tuberculosis and 48 patients with lung cancer.Results The levels of TNF-α in tuberculous pleural effusion were markedly higher than those in lung cancer(P<0.05).The levels of CEA and NSE in patients with lung cancer pleural effusions were higher than those with tuberculous pleural effusions(P<0.01).Detection of CEA in pleural effusion showed the highest levels in adenocarcinoma of the lungs.The levels of NSE in pleural effusion were the highest in small cell lung cancer.Combined detection of CEA and NSE in pleural effusions showed higher sensitivity(92.0%) and accuracy(86.3%).Conclusions Detection of TNF-α,CEA and NSE in pleural effusion is of great clinical value in diagnosis and differential diagnosis between tuberculosis and malignant pleural effusions.Combined measurement of CEA and NSE in malignant pleural effusions showed higher diagnostic sensitivity for lung cancer.更多还原