胸腔积液联合检测CEA、CYFRA21-1、β_2-MG的意义

THE UTILITY VALUE OF THREE MARKERS DIFFERENTIATING BENIGN AND MALIGNANT PLEURAL EFFUSION

目的:目前临床用以鉴别良恶性胸液的肿瘤标记物不下几十种,联合检测优于单一检测已成共识,但结果判定复杂,本文选择临床常用三种肿瘤标记物联合检测,其结果代入判别式,以提高临床诊断的符合率。方法:选择经病理证实的良恶性胸液各30例,用放射免疫分析法检测其CEA、CYFRA21-1、β2-MG水平、通过判别分析对联检结果进行良恶性的判定。结果:3种标志物浓度在良恶性组中有显著差别P<0.01。3种标志物的敏感度、特异度、准确度分别为CEA(80%、93.3%、86.6%)、CYFRA21-1(80%、86.7%、83.3%)、β2-MG(83.3%、83.3%、83.3%)。将三种标记物带入判别式,得回代的敏感度、特异度、准确度为(86.7%、96.7%、91.7%)。结论:以上三种标记物联合检测,优于单一检测及任意两相联合检测,且其结果判定简单,明显提高了良恶性胸液诊断的准确率。

Objective：These days more than several decades tumor markers are used in clinic to differentiate benign and malignant pleural effusion. Combined determination is superior to individual,but judging method is complex. The three markers were measured in pleural effusion whose results were analysed by discrimination to increasing accuracy of clinic diagnosis. Methods：Radioimmunoassay was used to detect the levels of CEA、CYFRA21-1、β2-MG of pleural effusion in 30 malignant and 30 benign pleural patients, discrimination was used to evaluate the combined result. Results： Significant differences of the three markers were found in benign and malignant pleural effusion （all p〈0.01）. Sensitivity、specificity and accuracy of the three tumor markers were as following： CEA （80%,93.3%,86.6%）, CYFRA21-1 （80%,86.7%,83.2%）β2-MG （83.3%,83.3%,83.3%）. sensitivity、specificity and accuracy of the combined result by discriminant faction were： 90%,90%,90%. Conclusions： Accuracy of Combined determination were increased of differentiating benign and malignant pleural effusion.