【摘要】 目的 探究胸腔积液中肿瘤标志物检测对良恶性胸腔积液的诊断价值。方法 选取52例胸腔积液患者,根据临床诊断结果分为肺癌试验组(恶性, 26例)和良性对照组(良性, 26例)。两组均同步抽取患者的胸腔积液和静脉血,采用电化学发光免疫法同步检测肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段(Cyfra21-1)、神经元特异性烯醇化酶(NSE)]水平。比较两组胸腔积液、血清中肿瘤标志物水平,并比较肿瘤标志物联合检测与单项检测的敏感度、特异度、准确度。结果 良性对照组胸腔积液中CEA、CA125、Cyfra21-1、NSE水平分别为(2.99±1.25)ng/ml、(25.55±9.52)U/ml、(2.86±2.77)ng/ml、(8.75±8.24)ng/ml,血清中CEA、CA125、Cyfra21-1、NSE水平分别为(1.88±2.35)ng/ml、(23.15±5.93)U/ml、(1.75±2.05)ng/ml、(5.85±5.43)ng/ml；肺癌试验组胸腔积液中CEA、CA125、Cyfra21-1、NSE水平分别为(121.24±127.35)ng/ml、(351.11±249.81)U/ml、(105.27±110.85)ng/ml、(35.99±41.26)ng/ml,血清中CEA、CA125、Cyfra21-1、NSE水平分别为(41.33±64.36)ng/ml、(189.48±105.85)U/ml、(26.46±31.23)ng/ml、(17.18±21.26)ng/ml。肺癌试验组患者胸腔积液和血清中CEA、CA125、Cyfra21-1、NSE水平均明显高于良性对照组(P<0.05)；肺癌试验组患者胸腔积液中CEA、CA125、Cyfra21-1、NSE水平均明显高于血清中肿瘤标志物水平(P<0.05)。CEA+CA125+Cyfra21-1+NSE联合检测的敏感度、特异度、准确度均高于CEA、CA125、Cyfra21-1、NSE单项检测(P<0.05)。结论 联合检测胸腔积液患者血清和胸腔积液中CEA、CA125、Cyfra21-1、NSE肿瘤标志物水平具有较高的敏感度、特异度、准确度,可应用于临床上良恶性胸腔积液的诊断,提高临床诊断准确率,为临床治疗提供参考。更多还原

【Abstract】 Objective To explore the diagnostic value of tumor markers in benign and malignant pleural effusion. Methods 52 patients with pleural effusion were divided into lung cancer experimental group(malignant,26 cases) and benign control group(benign, 26 cases) according to clinical diagnosis. Pleural effusion and venous blood of patients were respectively extracted synchronously. Tumor markers [carcinoembryonic antigen(CEA),glycoprotein antigen 125(CA125), cytokeratin 19 fragment(Cyfra21-1) and neuron-specific enolase(NSE)] levels were simultaneously detected by electrochemiluminescence immunoassay. The levels of tumor markers in pleural effusion and serum were compared between the two groups, and the sensitivity, specificity and accuracy of the combined and single detection of tumor markers were compared. Results In benign control group, the levels of CEA, CA125, Cyfra21-1 and NSE in pleural effusion were(2.99±1.25) ng/ml,(25.55±9.52) U/ml,(2.86±2.77) ng/ml and(8.75±8.24) ng/ml; the serum CEA, CA125, Cyfra21-1 and NSE levels were(1.88±2.35) ng/ml,(23.15±5.93) U/ml,(1.75±2.05) ng/ml and(5.85±5.43) ng/ml. In lung cancer experimental group, the levels of CEA, CA125, Cyfra21-1 and NSE in pleural effusion were(121.24±127.35) ng/ml,(351.11±249.81) U/ml,(35.99±41.26) ng/ml, and(105.27±110.85) ng/ml; the serum CEA, CA125, Cyfra21-1 and NSE levels were(41.33±64.36) ng/ml,(189.48±105.85) U/ml,(26.46±31.23) ng/ml and(17.18±21.26) ng/ml. The levels of CEA, CA125, Cyfra21-1 and NSE in pleural effusion and serum of lung cancer experimental group were significantly higher than those of benign control group(P<0.05). The levels of CEA, CA125, Cyfra21-1 and NSE in pleural effusion of lung cancer experimental group were significantly higher than the levels of tumor markers in serum(P<0.05). The sensitivity, specificity and accuracy of combined detection of CEA+CA125+Cyfra21-1+NSE were higher than those of single detection of CEA, CA125, Cyfra21-1 and NSE(P<0.05). Conclusion The combined detection of CEA, CA125, Cyfra21-1 and NSE tumor markers in the serum and pleural effusion of patients with pleural effusion has high sensitivity, specificity and accuracy, which can be applied to the diagnosis of benign and malignant pleural effusion in clinical practice, improve the accuracy of clinical diagnosis and provide reference for clinical treatment.更多还原