CEA、CA199、SCC-Ag、NSE和CYFRA211在恶性胸腔积液中的诊断价值

The value of CEA,CA199,SCC-Ag,NSE and CYFRA211 in the diagnosis of malignant pleural effusion

目的探讨胸腔积液中CEA、CA199、SCC-Ag、NSE和CYFRA211等5种肿瘤标志物单独及其组合检测对肺癌的诊断价值。方法采用电化学发光法(ECL)对366例胸腔积液中的肿瘤标志物进行检测分析。结果肺部恶性胸腔积液CEA、CA199、SCC-Ag、NSE和CYFRA211水平明显高于良性胸腔积液(P<0.05)。CEA浓度在腺癌中最高,且明显高于鳞癌和小细胞癌(P<0.01),CA199、CYFRA211在腺癌中最高,SCC-Ag在鳞癌中最高,NSE在小细胞肺癌中最高。五种标志物检验灵敏度、特异度、准确性分别为:CEA(86.8%、84.6%、83.2%),CA199(45.2%、86.5%、76.0%),SCC-Ag(50.8%、82.2%、68.1%),NSE(46.2%、81.7%、74.5%),CYFRA211(78.5%、86.6%、80.4%)。CEA+CYFRA211组合检测最佳,其敏感度、特异度、准确度分别为91.6%、90.8%、89.2%。结论 CEA具有较高的灵敏度,且对腺癌有较高的特异度。CEA和CYFRA211联合检测时可显著提高对恶性胸腔积液的诊断价值。

Objective To investigate the diagnostic value of 5 kinds of tumor markers, such as CEA, CA199, SCC-Ag, NSE and CYFRA211 in lung cancer. Methods The tumor markers in 366 cases of pleural effusion were detected by the method of electrochemical luminescence （ECL）. Results The levels of CEA, CA199, SCC-Ag, NSE and CYFRA211 in malignant pleural effusion were significantly higher than those in benign （P〈0.05）. CEA concentration was the highest in adenocarcinoma, and this was significantly higher than in squamous cell carcinoma and small cell carcinoma （P〈O.01）. CA199, CYFRA211 were the highest in adenocarcinoma, SCC-Ag was the highest in squamous cell carcinoma, NSE was the highest in small cell lung cancer. The sensitivity （%）, specificity （%） and accuracy （%） of the five markers were CEA（86.8, 84.6,83.2）, CA199（45.2,86.5,76.0）,SCC-Ag（50.8,82.2,68.1）,NSE（46.2,81.7,74.5） and CYFRA211 （78.5,86.6,80.4）. The combination detection of CEA＋CYFRA211 was the best, and the sensitivity, specificity and accuracy were 91.6%, 90.8% and 89.2% respectively. Conclusion CEA is with a high sensitivity, and a high degree of specificity to adenoeareinoma. The combination detection of CEA and CYFRA211 can significantly improve the diagnostic value of malignant pleural effusion.