腺苷脱氨酶和癌胚抗原联合检测在良恶性胸腔积液鉴别诊断中的价值

The differential diagnosis value of the combined detection of ADA,CEA on benign and malignant pleural effusion

目的探讨腺苷脱氨酶(ADA)和癌胚抗原(CEA)联合检测在临床良恶性胸腔积液鉴别诊断中的价值。方法采用速率法检测胸腔积液ADA活性,免疫化学发光法检测胸腔积液CEA的含量。结果 63例结核患者胸腔积液CEA阳性4例,阳性率为6.3%;24例癌性胸腔积液CEA检测阳性19例,阳性率为79.2%。癌性胸腔积液CEA阳性率明显高于结核性胸腔积液组,差异有统计学意义(P<0.01)。ADA的活性在结核性和癌性胸腔积液中分别为(69.5±13.2)U/L和(13±6.3)U/L,以ADA>40 U/L为诊断结核的临界值,其阳性率为73%(46/63)。结论联合检测胸腔积液ADA、CEA在结核性胸腔积液与癌性胸腔积液鉴别诊断中有重要的临床意义。

Objective To investigate the differential diagnosis value of the combined detection of adenosine deaminase（ADA） and carcinoembryonic antigen（CEA）on benign and malignant pleural effusion. Methods The activity of pleural fluid ADA was determined by performance rate method, and the content of pleural fluid CEA was tested by immunochemilu-minometric assay. Results 4 cases out of 63 patients with tubereulosis（TB） was tested positive for pleural fluid CEA,the positive rate was 6.3 %;19 cases out of 24 patients with malignant pleural effusion was tested positive for CEA,the positive rate was 79.2%. The positive rate of pleural fluid CEA in malignant pleural effusion group was significantly higher than that of tuberculous pleural effusion with statistical difference（P〈0.01）. The activities of ADA in tuberculous and malignant pleural effusion were （69.5 ±13.2）U/L and （13 ± 6.3）U/L respectively. Taken the ADA〉40 U/L as the threshold for the diagnosis of tuberculosis, the positive rate was 73 % 〈46/63）. Conclusion Combined detection of pleural fluid ADA,CEA in tuberculous pleural effusion and malignant pleural effusions in the differential diagnosis has important clinical significance.