胸腹水中端粒酶活性癌胚抗原与细胞学联合检查的临床诊断价值初探

THE CLINICAL VALUE OF COMBINED USE OF TELOMERASEACTIVITY,CEA AND CYTOLOGY IN THE DETECTIONOF PLEURAL EFFUSION

目的观察胸腹水中端粒酶活性(TA)、癌胚抗原(CEA)与脱落细胞学联合检查诊断恶性胸腹水性质的价值。方法分别应用酶联免疫吸附试验(ELISA)与化学发光免疫分析(CLIA)方法对200例良恶性胸腹水中的TA、CEA进行检测,同时进行胸腹水脱落细胞学检查。结果恶性胸腹水TA与CEA水平显著高于良性胸腹水中TA与CEA含量(P均<0.01)。应用TA诊断恶性胸腹水的阳性率为80.9%,特异性为86.0%,准确性为92.9%;CEA诊断阳性率为64.3%,特异性为91.8%,准确性为76.0%;TA+CEA诊断阳性率为90.4%,特异性为89.4%,准确性为90.0%。结论 TA是判断良恶性胸腹水的性质的较为准确和敏感的指标,联合测定CEA含量,同时进行脱落细胞学检查可明显提高恶性胸腹水的阳性诊断率。

Objective To determine the clinical value of the combined use of telomerase activity（TA）,carcino-embryonic antigen（CEA） and cytology in the detection of pleural effusion.Methods The concentrations of TA and CEA in pleural effusion were respectively determined by EILSA and CLIA.Meanwhile,the pleural effusion cytology was performed.Results The levels of TA and CEA in malignant pleural effusion were significantly higher than those in the benign pleural effusion（P0.01）.The TA Detection revealed that the positive rate of malignant pleural effusion was 80.9%,the specificity was 86.0% and the accuracy was 92.9%.The CEA detection showed that the positive rate of malignant pleural effusion was 64.3%,the specificity was 91.8% and the accuracy was76.0%.The comined use of TA and CEA showed the positive rate of malignant pleural effusion was 90.4%,the specificity was 89.4% and the accuracy was 90.0%.Conclusion It is accurate and sensitive when TA detection is applied to determine the nature of pleural effusion.It can significantly improve the positive rate when the detection of TA,CEA and cytology in pleural effusion were combined in the diagnosis of malignant pleural effusion.