联合检测CEA、ADA、TP、LDH、HBD在鉴别诊断良、恶性胸腹水中的意义

Combined Detection of CEA,ADA,TP,LDH,and HBD in Differential Diagnosis of Benign or Malignant Hydrothorax and Ascites

目的探讨联合检测癌胚抗原(cancer embryo antigen,CEA)、腺苷脱氨酶(adenosine deaminase,ADA)、总蛋白(total protein,TP)、乳酸脱氢酶(lactic dehydngenase,LDH)、α-羟丁酸脱氢酶(α-hydroxybutyric acid dehydrogenase,HBD)在鉴别诊断良、恶性胸、腹水中的临床意义。方法分别测定52例癌性胸、腹水,70例良性胸、腹水CEA、ADA、TP、LDH、HBD含量。对测得数据用SPSS13.0统计软件建立数据库,运用Bayes判别分析方法进行统计分析,建立判别函数进行回顾性效果评价,另收集172例良、恶性胸、腹水资料对建立的判别函数进行验证。结果除ADA测定结果在良、恶性胸、腹水中差异无统计学意义(P>0.05)外,其它四项指标两组间比较差异均有统计学意义(P<0.001),Bayes判别函数对胸腹水良恶性正确判别率分别为良性91.4%、恶性86.5%,与交互验证的方法得出的结果一致。验证资料对Bayes判别函数验证评价正确率分别为良性88.7%,恶性85.5%。结论恶性组CEA、TP、LDH、HBD明显高于良性组,但ADA在两组中差异无显著性(P>0.05),建立的Bayes函数在良、恶性胸腹水的判别中有一定意义。

Objective To combinedly determine cancer embryo antigen （CEA）, adenosine deaminase （ADA）, total protein（TP）, lactic dehydngenase （LDH）, and α- hydroxybutyric acid dehydrogenase （HBD） in the identification of diagnosis of benign or malignant hydrothorax and ascites. Methods Totally 52 cases of malignant hydrothorax and ascites and 70 cases of benign hydrothorax and ascites were determined CEA, ADA, TP, LDH, and HBD value. A database was established by using statistical software SPSS13.0. The measured data were statistically analyzed using Bayes discriminant analysis method. The discriminant function was established to retrospectively evaluate the significance of combined determination, and the information about 172 cases of benign or malignant hydrothorax and ascites was collected to verify the discriminant function. Results There was statistical significance in CEA, TP, LDH, and HBD between benign hydrothorax and ascites group and malignant hydrothorax and ascites group （P〈 0. 001）, but the difference has no statistical significance between the two groups in ADA （P〉0.05）. Bayes discriminant function determined the correct rate of 91.4 % for benign hydrothorax and ascites and that of 86.5 % for malignant hydrothorax and ascites, and these results were in accordance with the results verified from interactive verification method. Samples of Bayes information on the discriminant function verified the correct assessment rates of 88.7 % in benign hydrothorax and ascites and 85..5 % in malignant hydrothorax and ascites. Conclusions CEA, TP, LDH, and HBD in malignant group is significantly higher than those in benign group, but ADA has no statistical significant difference between the two groups （P〉0.05）. The establishment of the Bayes function is helpful in discrimination of benign or malignant hydrothorax and ascites.