癌胚抗原腺苷脱氢酶联合检测鉴别结核性和癌性胸腔积液

Combined Detection of Carcinoembryonic Antigen and Adenosine Deaminase for Identification of Tuberculous and Malignant Pleural Effusion

目的:探讨癌胚抗原(CEA)、腺苷脱氢酶(ADA)联合检测对鉴别诊断结核性和癌性胸腔积液的意义。方法:采集本院已确诊的98例胸腔积液患者的胸水和血清标本,其中结核性56例、癌性胸水42例,检测胸水和血清的CEA、ADA并进行定量分析。结果:CEA在结核性、癌性胸腔积液中的阳性率分别是8.9%、76.2%,特异度为91.1%;ADA活性在结核性和癌性胸腔积液中分别为(59.46±26.52)U/L和(15.82±6.84)U/L(P<0.01)。以P-ADA>40 U/L作为诊断结核的临界值,其敏感度为87.5%,特异度为90.1%,以P-ADA/S-ADA>1为临界值,其敏感度为94.6%,特异度为95.2%。结论:CEA、ADA联合检测对鉴别结核性和癌性胸腔积液的有一定的临床价值。

Objective： To investigate the clinical significance in combined detection of earcinoembryonic antigen （CEA） and adenosine deaminase （ADA） for differential diagnosis of tuberculous or carcinomatous pleural effusion. Methods：98 confirmed cases of pleural effusion with pleural effusion and serum samples were collected, 56 cases with TB and 42 cases with cancer into the study, the hydrothorax and blood serum were collected from patients with pleural effusion, the quantitation of CEA and ADA in hydrothorax and blood serum were analyzed. Results： The positive rate of CEA test was 8.9% in tuberculous and 76.2% in carcinomatous pleural effusion, respectively, with a specificity of 91. 1%. The levels of ADA in tuberculous and carcinomatous pleural effusion were （59.46 ± 26.52） U/L and （ 15. 82± 6. 84） U/L, respectively（ P 〈 0. 01 ）. Diagnosis for tuberculous pleural effusion yielded 87.5% sensitivity and 90. 1% specificity using P-ADA 〉 40U/L as the cut-off value, and 94.6% sensitivity and 95. 2% specificity using P-ADA/S-ADA 〉 1 as the cut-off value. Conclusion： The combined detection of CEA and ADA for the differential diagnosis of tuberculous or carcinomatous pleural effusion can be useful in clinical practices.