【摘要】 目的探讨端粒酶、癌胚抗原、腺苷脱氨酶联合检测对恶性和结核性胸腔积液的鉴别诊断价值。方法选择恶性胸腔积液31例,结核性胸腔积液35例,采用聚合酶联反应-酶联免疫吸附分析法(PCR-ELISA)检测胸腔积液端粒酶活性,用酶免疫分析法(EIA)检测胸腔积液CEA水平,用比色分析法检测胸腔积液ADA含量,并对测定结果进行统计学处理。结果端粒酶活性测定诊断恶性胸腔积液的灵敏度为0.870,特异度为0.943。CEA诊断恶性胸腔积液的灵敏度为0.744,特异度为0.886。ADA诊断恶性胸腔积液的灵敏度为0.967,特异度为0.971,正确性为0.969。结论端粒酶活性的测定,在良恶性胸水的鉴别诊断中具有重要价值,但存在假阴性和假阳性,若与胸水CEA、ADA联合检测,对良恶性胸水的鉴别诊断意义更大。更多还原

【Abstract】 Objective To investigate the values of combined pleural effusion testing of telomerase, CEA and ADA for differential diagnosis of tuberculous and malignant pleural effusion.Methods 31 case with malignant and 35 case with tuberculous pleural effusion were enrolled into the study. Telomerase activity in pleural effusion was tested by means of PCR-ELISA, and CEA levels in pleural effilsion were tested by using EIA method. ADA contents in pleural effusion was tested by means of colorimetric analysis. All the results were analyzed using statistical method. Results The sensitivity of telomerase activity testing for diagnosing malignant pleural effusion was 0.870, and the specificity 0.943. The sensitivity of CEA testing for diagnosing malignant pleural effusion was 0.774, and the specificity 0.886. The sensitivity of ADA for diagnosing malignant pleural effusion was 0.774, and the specificity 0.886. The sensitivity of ADA for diagnosing malignant pleural effusion was 0.839, and the specificity 0.014. The sensitivity of the combined testing of telomerase, CEA and ADA for diagnosing malignant pleural effusion was 0.967, and the specificity 0.971 and the accuracy rate of 0.969. Conclusion The activity testing of telomerase has important value in differential diagnosis of benign and malignant pleural effusion, but false negative and false positive rates remain existing. The combined testing of CEA and ADA with telomerase can be more valuable in the differential diagnosis of benign from malignant pleural effusion.更多还原