胸水CEA、NSE、CYFRA21-1检测对恶性胸腔积液的诊断价值

The diagnostic value of detecting of CEA,CYFRA21-1,NSE,in the malignant pleural effusion

目的:探讨癌胚抗原(CEA)、神经特异性烯醇化酶(NSE)、细胞角质蛋白19片断(CYFRA21-1)联合检测对恶性胸腔积液的诊断价值。方法:采用放射免疫法测定176例病人胸腔积液中上述指标的含量。结果:62例恶性胸腔积液(肺癌)组的测定值显著高于70例非恶性胸腔积液组的测定值(P<0.01)。CEA、NSE、CYFRA21-1在肺癌中的腺癌、小细胞癌、鳞癌的测定值最高,阳性率亦最高。两项联检NSCLC以CY-FRA21-1、CEA阳性率较高,SCLC以NSE、CYFRA21-1阳性率较高。三项标志物联合检测诊断肺癌并恶性胸腔积液的敏感性显著高于单项检测和两项联检。结论:三者联检有助于恶性胸腔积液的诊断。在肺癌并恶性胸腔积液中,CEA对腺癌,NSE对小细胞癌、CYFRA21-1对鳞癌有较高的敏感性。

Objective：To explore the diagnostic value of combined detection of CEA, CYFRA21 - 1, NSE in the malignant pleura effusion. Methods： The Levels of CEA,CYFRA21 - 1 ,NSE in the pleural effusion of 176 patients were assayed by radioimmunity method. Results： CEA, CYFRA21 - 1 ,NSE levels were notably elevated in 62 malignant pleura effusion compared with 70 benign pleura effusion （P 〈 0.01 ）. The levels of CEA, NSE, CYFRA21 - 1 were notably elevated in adenocarcinoma, squamous cell carcinoma and small cell lung cancer respectively. Of the combination of two index in NSCLC,the accuracy of the combined detection of CEA, CYFRA21 - 1 were higher than others;In SCLC the accuracy of the combined detection of NSE, CYFRA21 - 1 were higher than others ;The sensitivity of the combined detection of CEA, CYFRA21 - 1, NSE were higher than those of single and double index. Conclusion： The combined detection of CEA,CYFRA21 -1 ,NSE were of clinical importance in the diagnosis of malignant pleura effusion diagnosis. In lung cancer with the malignant pleura effusion diagnosis, the level of CEA NSE CYFRA21 -1 were more sensitive in adenocarcinoma,squamous cell carcinoma and small cell lung cancer.