联合检测ADA、CEA和CYFRA21-1对鉴别结核性和恶性胸腔积液的诊断价值

Diagnostic value of combined detection of ADA,CEA and CYFRA21-1 in patients with tuberculosis and malignant pleural effusion

目的探讨腺苷脱氨酶(ADA)和癌胚抗原(CEA)在结核性和恶性胸腔积液鉴别诊断中的价值,同时分析血清CEA和细胞角蛋白19片段(CYFRA21-1)对恶性胸腔积液的诊断价值。方法对30例结核性胸膜炎和30例恶性肿瘤患者胸腔积液中的ADA和CEA水平进行测定,并分析血清CEA和CYFRA21-1水平,进行统计学分析。结果胸腔积液中结核组ADA水平明显高于恶性组,而恶性组CEA水平高于结核组,差异均有统计学意义(P<0.05)。胸腔积液ADA对结核组诊断的敏感性及特异性分别为96.7%、96.4%,CEA对恶性组诊断的灵敏性及特异性分别为92.9%、96.7%。血清CEA和CYFRA21-1水平在恶性组中均高于结核组,差异有统计学意义(P<0.05)。结论胸腔积液中ADA和CEA水平在结核性和恶性胸腔积液组的鉴别诊断中具有重要的临床意义,联合检测血清CEA和CYFRA21-1能提高恶性胸腔积液的诊断率。

Objective To explore the value of adenosine deaminase （ADA） and careino-embryonie antigen （CEA） in the diagnosis of patients with tuberculosis and malignant pleural effusion, and analyze the diagnostic value of serum CEA and cytokerantin-19-fragment （CYFRA21-1） as biomarkers of malignant effusions. Methods 30 patients with tuberculosis effusions and 30 patients with malignant effusions were selected in this study.The levels of ADA, CEA of pleural effusions and CEA,CYFRA21-1 of serum were detected and then to perform statistics analysis. Results The levels of ADA in pleural effusion were significantly higher in the tuberculosis group than the cancer group, and CEA levels were significantly higher in the cancer group （P〈O.05）. The sensitivity and specificity of ADA of pleural effusion in the tuberculosis group were 96.7% and 96.4%, respectively ; the sensitivity and specificity of CEA in the cancer group were 92.9% and 96.7%, respectively. Serum levels of CEA and CYFRA21-1 were both significantly higher in the malignant group than those of tuberculosis group （P〈0.05）. Conclusion The levels of ADA and CEA in pleural effusion had great significance for distinguishing tuberculosis and malignant pleural effusions. Combined detection of serum CEA and CYFRA21-1 in the diagnosis of malignant pleural effusions had important clinical significance.