腺苷脱氨酶、癌胚抗原和结核抗体检测对鉴别良、恶性胸腔积液的诊断价值

Rescearch on Adenosine Deaminase,Carcinoembryonic Antigen,and Tuberculosis Antibody Detection in the Different Diagnosing Benign and Malignant Pleural Effusion

目的:评价腺苷脱氨酶(ADA)、癌胚抗原(CEA)、结核抗体(TB-Ab)对鉴别良、恶性胸腔积液的诊断价值。方法:检测126例结核性胸腔积液、58例恶性胸腔积液患者胸水中的ADA、CEA、TB-Ab水平。结果:结核组胸水中ADA水平明显高于恶性组(P<0.01);恶性组胸水CEA水平明显高于结核组(P<0.01);CEA在结核性和癌性胸腔积液中的阳性率分别为7.9%和58.6%,特异性为92.1%,TB-Ab在结核性和癌性胸腔积液中的阳性率分别为78.6%和8.6%,特异性为91.4%;以P-ADA>40U/L为诊断结核的临界值,其敏感性为77.8%,特异性为84.5%。结论:测定胸水ADA、CEA和TB-Ab水平是鉴别良、恶性胸腔积液的重要方法之一。

Objective：To evaluate tadenosine deaminase（ADA）,carcinoembryonic antigen（CEA）,tuberculosis antibody（TB-Ab） in the differentiating benign and malignant pleural effusion.Methods：The ADA,CEA and TB-Ab levels of 126 patients with tuberculous pleural effusion and 58 patients with malignant pleural effusion were detected.Results：The ADA levels of pleural fluid in the TB group was significantly higher than in the malignant group（P〈0.01）;The CEA levels of pleural fluid in the malignant group was significantly higher than in the TB group（P〈0.01）.The positive rate of CEA is 7.9% in tuberculous pleural effusion and 58.6% in malignant pleural effusion,and the specificity is 92.1%;the positive rate of TB-Ab is 78.6% in tuberculous pleural effusion and 8.6% in malignant pleural effusion,and the specificity is 91.4%;the sensitivity is 77.8% and the specificity is 84.5% on the basis of P-ADA 40U /L threshold for the diagnosis of tuberculosis.Conclusion：The determination of pleural fluid ADA,CEA,and TB-Ab levels is one important way in differentiating benign and malignant pleural effusion.