血清糖链抗原125、糖链抗原19-9、癌胚抗原在结核性胸膜炎中诊断价值的研究

The value of serum carbohydrate antigen 125,carbohydrate antigen-19-9 and carcinoembryonic antigen in the diagnosis of tuberculous serous cavity effusion

目的研究肿瘤标记物水平对胸腔积液的诊断及其病因的相关性。方法统计本院胸腔积液患者400例,其中良性积液233例,恶性积液156例,检测各组胸腔积液及血清中CA125、CA19-9和CEA等肿瘤标志物及ADA水平,并应用t检验、ROC曲线等进行统计学分析。结果纳入的389例患者中良性组(233例)占58.3%,恶性积液组(156例)占39.0%,其中前5位病因分布依次为结核性胸膜炎、支气管肺癌、肺炎、心力衰竭、脓胸。恶性胸腔积液组患者胸水、血清肿瘤标志物水平明显高于良性组,差异有统计学意义(P<0.05)。CA19-9+CA125+CEA联合检查可提高良恶性胸腔积液鉴别的特异度及敏感度。结论 CA19-9、CA125和CEA联合检测,结合影像学、PPD实验有利于鉴别肿瘤与结核性胸膜炎引起胸腔积液的临床诊断。

Objective To study the clinical significance of serum tumor markers in the diagnosis of pleural effusion（ PE） and the correlation with it. Methods In our hospital 400 cases that were diagnosed as pleural effusion patients were enrolled,including 233 benign PE patients and 156 maligant PE patients. The levels of CA125,CA19-9,CEA and ADA in pleural effusion and serum between the two groups were detected. t test and the receiver operating characteristic（ ROC） curve analysis were used for statistical analysis. Results In 389 patients,benign group（ 233 cases） accounted for 58. 3%,malignant effusion group（ 156 cases） accounted for 39. 0%,the top 5 causes were tuberculous pleurisy,lung cancer,pneumonia,heart failure,empyema. Pleural effusion in patients with malignant pleural effusion group and the serum level of tumor markers were significantly higher than that in the benign group,and the differences were statistically significant（ P〈 0. 05）. The joint detection of CA19-9 ＋ CA125 ＋ CEA can improve the specificity and sensitivity in the diagnosis of benign and malignant pleural effusion.Conclusion Combined detection of CA125,CA19-9 and CEA had a certain clinical value for the diagnosis of benign and malignant PE with the help of iconography and PPD experiment.