hs-CRP、VEGF、CEA联合检测在鉴别良、恶性胸腹腔积液中的临床价值

Clinical Values of Combined Detection of hs-CRP,VEGF and CEA in Distinguishing Diagnosis of Benign and Malignant Pleural/Ascitic Effusion

目的:探讨hs-CRP(high-sensitivity CRP,超敏CRP)、VEGF(Vascularendothelial growth factor,血管内皮生长因子)、CEA(癌胚抗原)对胸腹腔积液鉴别诊断的临床价值。方法:应用乳胶增强散射比浊法、EILSA方法及电化学发光免疫分析技术,检测81例患者胸腹腔积液中hs-CRP、VEGF和CEA的浓度。结果:恶性胸腹腔积液组hs-CRP浓度为[(10.03±10.86)mg/l]与良性胸腹腔积液组[(3.24±4.56)mg/l]比较,差异非常显著(P<0.01);恶性胸腹腔积液组VEGF浓度为[(321.41±295.91)pg/ml]与良性胸腹腔积液组[(31.00±92.87)pg/ml]比较,差异非常显著(P<0.01);恶性胸腹腔积液组CEA浓度为[(227.46±738.08)ng/ml]与良性胸腹腔积液组[(1.10±1.12)ng/ml]比较,浓度明显高于良性组(P<0.05);hs-CRP、VEGF和CEA恶性胸腹腔积液中检测的敏感性分别为47%、58%和47%、特异性为57%、96%和98%;在区分良恶性胸腹腔积液时,hs-CRP、VEGF和CEA联合检测优于单项检测。结论:恶性胸腹腔积液组中hs-CRP、VEGF和CEA水平明显高于良性组。hs-CRP、VEGF及CEA联合检测可区分良、恶性胸腹腔积液的性质,其中以VEGF及CEA联合检测为最佳,对于良、恶性胸腹腔积液的鉴别诊断具有较高的临床价值。

Objective：To investigate the effect of combined detection of hs-CRP,VEGF and CEA on the benign and malignant of fluid in the chest and ascites of patients with pleural effusion to investigate the diagnostic value of three.Methods：The hs-CRP was deter-mined by nephe-lometric immunoassay.The VEGF was detected using double antibody sandwich ELISA and compared with CEA was done by electrochemilumin-escence immunoassay in 81 patients with hydrothorax or ascites and sera.Results：The pleural/Ascitic fluid of hs-CRP in patients with malignant pleural effusion was（[10.03±10.86）mg/l] while benign Pleural /Ascitic Fluid were（[3.24±4.56）mg/l（]p0.01）;The pleural/Ascitic fluid of VEGF in patients with malignant was [（321.41±295.91）pg/ml]while benign Pleural /As-citic Fluid was[（31.00±92.87）pg/ml ]（p0.01）;The pleural fluid of CEA in patients with malignant pleural effusion was[（227.46± 738.08）ng/ml]while benign Pleural /Ascitic Fluid was [（1.10 ±1.12）ng/ml]（p0.05）.The sensitivity for each marker of hs-CRP,VEGF and CEA in the diagnosis of malignant Pleural/Ascitic effusion was 47%,58% and 47%,respectively,and specificity was 57%,96% and 98% respectively.The combined detection of hs-CRP,VEGF and CEA were superior to individual testing.Conclusion：The hs-CRP,VEGF and CEA in malignant Pleural/Ascitic effusion were significantly higher than those in benign Pleural/Ascitic effusion.The combined use of hs-CRP,VEGF and CEA can detect the nature of malignant and benign Pleural/Ascitic effusion,and the combined use of VEGF and CEA is the best.,which have high clinical values in the differential diagnosis of Pleural/Ascitic effusion.