血清癌胚抗原及胸腔积液癌胚抗原与肺癌的相关性研究

The Relativity Between Blood and Pleural Effusion CEA and Lung Cancer

目的探讨胸水、血清癌胚抗原(CEA)与肺癌的相关性。方法回顾性分析2008-01～2010-12间,我院住院的160例胸腔积液患者血清及胸水CEA水平。结果恶性组血清及胸水CEA水平及阳性率均较良性组增高(P<0.05),恶性组胸水CEA水平、阳性率明显高于血清CEA(P<0.05)。良性组胸水、血清CEA水平均低于正常值上限,胸水CEA水平、阳性率高于血清CEA,但差异无统计学意义(P>0.05);恶性组胸水/血清CEA比值高于良性组(P<0.05)。胸水较血清CEA测定恶性胸水的敏感性、特异度高(P<0.05)。胸水CEA>120μg/L明显高于15.0μg/L,<胸水CEA 120μg/L找到癌细胞比率(P<0.05)。而血清5.0μg/L<血清CEA 80μg/L与血清CEA<5.0μg/L找到癌细胞比率比较,差异无统计学意义(P>0.05)。结论胸水与血清CEA水平及其比值的联合分析,有助于提高良、恶性胸水的诊断准确率。

Objective To investigate the correlation of the pleural fluid,serum carcinoembryonic antigen（CEA） and lung cancer.Methods A retrospective analysis of 160 cases,from 2008-01 to 2010-12,who were in our hospital with pleural effusion.The serum and pleural fluid CEA level were studied.Results The serum and pleural fluid CEA levels and positive rate in malignant group were higher than benign group（P0.05）.The malignant group of pleural fluid CEA level and positive rate was significantly higher than the serum CEA（P0.05）.In benign group,pleural fluid and serum CEA levels were lower than the upper limit of normal,pleural fluid CEA level and positive rate were higher than serum CEA,but the difference was not statistically significant（P0.05）;Pleural fluid / serum CEA ratio of the malignant group higher than the benign group（P0.05）.The sensitivity and specificity of pleural fluid were higher than serum in the determination of CEA（P0.05）.The ratio of cancer cells findings in pleural fluid CEA over 120 μg/L was significantly higher than pleural fluid CEA among 15.0 μg/L to 120 μg/L（P0.05）.However,serum CEA among 5.0 μg/L to 80 μg/L has no difference with serum CEA lower 5.0 μg/L,the difference was not statistically significant（P0.05）.Conclusion The conjoint analysis of the pleural fluid,serum CEA level and the ratio might be helpful in the improvement of the diagnostic accuracy rate of benign and malignant pleural effusion.