蛋白芯片技术在良恶性胸腹水鉴别诊断中的意义

THE APPLICATION OF PROTEIN CHIP IN THE DIAGNOSES OF MALIGNANT/BENIGN ASCITES AND HYDROTHORAX

[目的]探讨蛋白芯片技术在良恶性胸腹水积液鉴别诊断中的意义。[方法]采用蛋白芯片定量方法检测胸腹水中CEA、CA125、CA-199、CA153、CA242、Ferriti的含量。[结果]恶性组患者的胸腹水及血清中CEA、CA125、CA-199、CA153、CA242、Ferriti的含量均明显高于非结核性良性胸腹水患者组和结核性胸腹水患者组(P﹤0.01或P﹤0.05);恶性组胸腹水中的CEA、CA125、CA-199、CA153、CA242和Ferriti的含量明显高于血清中各相应肿瘤标志物的含量(P﹤0.05)。在恶性组胸腹水中CEA、CA125、CA-199、CA153、CA242和Ferriti的敏感性分别为55.7%、50.1%、41.8%、39.2%、46.8%和48.1%,特异性分别为82.8%、71.7%、73.9%、77.1%、80.9%和66.9%。联合检测时敏感性为89.9%,特异性为87.5%。[结论]单一检测胸腹水积液中某一种肿瘤标志物的敏感性和特异性较差,若采用蛋白芯片定量技术联合检测多种肿瘤标记物则能提高检测的敏感性和特异性,因而对胸腹水性质的鉴别诊断有重要的临床价值。

[ Objective] To explore the effeet of protein chip in the diagnoses of malignant/benign ascites and hydrothorax. [Methods] The concentrations of CEA, CA125, CA-199, CA153, CA242 and Ferriti in aseites or hydrothorax were measured by the protein chip technology. [Results] The concentrations of CEA, CA125, CA-199, CA153, CA242 and Ferriti in malignant aseites/hydrothorax and serum were significantly higher than those in benign ascites/hydrothorax and tubereuloascites/hydrothorax. For patients with malignant the concentrations of CEA, CA125, CA-199, CA153, CA242 and Ferriti in ascites/hydrothorax were significantly higher than that in serum. And the sensitivity of CEA, CA125, CA-199, CA153, CA242 and Ferriti in the diagnosis of malignant/benign aseites and hydrothorax were 55.7%, 50.1%, 41.8%, 39.2%, 46.8% and 48.1%, respectively, the specificity of each marker were 82.8%, 71.7%, 73.9%, 77.1%, 80.9% and 66.9%, respectively. The combined sensitivity of the above six markers was 89.9% and the combined specificity was 87.5%. [Conclusion] A single tumor marker was not sensitive and specific enough in the estimation of the property of aseites/hydrothorax, but the detection of multi-markers with protein ehip teehnology help improve the sensitivity and specificity therefore to provide valuable information for elinical diagnosis of nvalignant/benign aseites and hydrothorax.