端粒酶活性和DNA异倍体及癌胚抗原联检实验诊断恶性胸腔积液

Combined Detection of Telomerase Activity and DNA Aneuploid and CEA for Laboratory Diagnosis of Malignant Pleural Effusion

目的评价联合检测胸腔积液中端粒酶活性(TA)、DNA异倍体和癌胚抗原(CEA)对实验诊断恶性胸腔积液的价值。方法应用端粒末端重复序列扩增-杂交-酶联免疫分析检测TA、流式细胞术检测DNA异倍体,应用磁性抗体分离酶免疫测定法检测CEA。比较单指标与指标联检的差别。结果单指标鉴别诊断恶性与良性胸腔积液的特异度、敏感度、准确率分别为。端粒酶0.961,0.800,0.870;DNA异倍体0.937,0.752,0.832;CEA0.898,0.515,0.682。联合检测上述指标鉴别诊断恶性与良性胸腔积液的特异度、敏感度、准确率分别为:TA+CEA0.866,0.824,0.842;DNA异倍体+CEA0.843,0.776,0.805;TA+DNA异倍体0.906,0.867,0.884;TA+DNA异倍体+CEA0.803,0.891,0.853。结论联合检测可进一步提高诊断恶性胸腔积液的敏感度和准确度,但可轻度降低特异性,其中以TA+DNA异倍体联检效果最佳,而联合TA与CEA的效果不理想。

Objective To appraise the value on combined detection of telomerase activity （TA）,DNA aneuploid and carcinoembryonic antigen （CEA） for the laboratory diagnosis of malignant pleural effusion. Methods TA,DNA aneuploid and CEA were detected by telomeroc repeat amplification protocol-hybridism-enzyme-linked immunosorbent assay,Flow cytometry and Magnetic antibody immunoenzymetric assay in pleural effusion,respectively. And the difference between single detection and combined detection was compared. Results The specificity,sensitivity and accuracy were：TA 0. 961,0. 800 and 0. 870;DNA aneuploid 0. 937,0. 752 and 0. 832;CEA 0. 898,0. 515 and 0. 682;TA＋CEA 0. 866,0. 824 and 0. 842; DNA aneuploid＋CEA 0. 843,0. 776 and 0. 805;TA＋ DNA aneuploid 0. 906,0. 867 and 0. 884;TA＋DNA aneuploid＋ CEA 0. 803,0. 891 and 0. 853. Conclusion Combined detection could improve the sensitivity and accuracy,but it could decrease the specificity merely. Combined use of TA detection with DNA aneuploid indicates much more advantage than of TA detection with CEA for the differential diagnosis of malignant pleural effusions from benign pleural effusions.