CEA、CA153检测联合胸膜活检对恶性胸腔积液的诊断价值

Diagnostic value of CEA,CA153 and pleural biopsy in malignant pleural effusion

目的探讨胸腔积液癌胚抗原(CEA)、糖链抗原153(CA153)检测联合胸膜活检诊断恶性胸腔积液的价值。方法收集经确诊为恶性胸腔积液35例及良性胸腔积液25例,回顾性分析比较患者胸腔积液CEA、CA153及胸膜活检的结果。结果恶性胸腔积液的CEA、CA153含量均高于良性胸腔积液者(P<0.01);CEA联合CA153检测的诊断灵敏度为71.4%,特异度为88.0%,优于单项CEA、CA153检测。当CEA、CA153检测联合胸膜活检时,其阳性诊断率为91.4%,明显高于CEA结合CA153检测的阳性诊断率(71.4%)(P<0.05)。结论胸腔积液CEA、CA153检测在恶性胸腔积液中的阳性率较高,可作为良好的筛选指标。胸腔积液CEA、CA153检测联合胸膜活检可明显提高恶性胸腔积液的诊断率。

Objective To investigate the diagnostic value of CEA, carbohydrate antigen 153 （CA153） and pleural biopsy in mali- gnant pleural effusion （PE）. Methods The results of CEA, CA153 and pleural biopsy were retrospectively analyzed in 35 patients with malignant PE and 25 with benign PE. Results CEA and CA153 levels in malignant PE were significantly higher than those in benign PE （P〈0.01）. The sensitivity and specificity of CEA plus CA153 in the diagnosis of malignant PE were 71.4% and 88.0%, respectively, and were superior to those of CEA or CA153. The diagnostic rate of combined use of CEA, CA153 and pleural biopsy in malignant PE was superior to that of CEAplus CA153 （91.4% vs 71.4%, P〈0.05）. Conclusion Hydrothoracic CEA and CA153 detection is helpful for the judgment of malignant PE. The combined use of CEA, CA153 and pleural biopsy can improve the diagnostic rate of malignant PE.