癌抗原125对于胸腔积液鉴别诊断的意义

The significance of cancer antigen 125 in differential diagnosis of patients with pleural effusion

目的研究血清和胸腔积液癌抗原125（CA125）检测对于胸腔积液鉴别诊断的意义。方法选取胸腔积液患者共228例进行回顾性分析，其中恶性胸腔积液80例，良性胸腔积液148例（包括结核性胸腔积液52例，炎性胸腔积液56例，漏出性胸腔积液40例），分别对其胸腔积液和血清CA125水平进行比较。结果99．56％（227／228）患者的胸腔积液CA125水平高于血清CA125水平。良性胸腔积液患者与恶性胸腔积液患者的血清CA125水平分别为（92．19±13．51）、（151．72±23．14）kU／L，差异有统计学意义（P〈0．05）；胸腔积液CA125水平分别为（710．38±66．03）、（3135．64±1404．92）kU／L，差异无统计学意义（P〉0．05）。恶性、结核性、炎性、漏出性胸腔积液患者血清CA125水平分别为（151．72±23．14）、（120．86±26．92）、（58．09±11．60）、（111．22±34．19）kU／L，恶性胸腔积液患者高于炎性胸腔积液患者，差异有统计学意义（P〈0．01），恶性胸腔积液患者与结核性、漏出性胸腔积液患者比较差异无统计学意义（P〉0．05）；恶性、结核性、炎性、漏出性胸腔积液患者胸腔积液CA125水平分别为（3135．64±1404．92）、（756．30±96．42）、（626．86±105．55）、（814．41±173．28）kU／L，恶性胸腔积液患者与结核性、炎性、漏出性胸腔积液患者比较差异无统计学意义（P〉O．05）。结论CA125对于胸腔积液性质的鉴别单独使用意义不大，血清CA125联合其他肿瘤标志物可提高肿瘤诊断率。在临床应用CA125进行辅助诊断时，需注意CA125的非特异度增高。

Objective To study the value of cancer antigen 125 （CA125） in the differential diagnosis of patients with pleural effusion. Methods Two hundred and twenty-eight patients with pleural effusion were selected and analyzed retrospectively,including 80 cases with malignant pleural effusion, 148 cases with benign pleural effusion （including 52 tuberculous pleural effusion,56 inflammatory pleural effusion and 40 transudative pleural effusion ）. The levels of CA125 in the pleural effusion and serum were detected and compared. Results The level of CA125 in the pleural effusion of 99.56%（227/228） of all the patients was higher than that in the serum. The serum CA125 levels of patients with benign and malignant pleural effusion had significant differences[ （92.19 ± 13.51 ） kU/L vs.（ 151.72 ± 23.14） kU/L,P 〈 0.05 ] ,but the levels of CA125 in the pleural effusion of benign and malignant patients had no significant difference [（710.38 ±66.03） kU/L vs. （3135.64 ± 1404.92） kU/L,P 〉0.05]. The levels of serum CA125 in the malignant,tuberculous,inflammatory and transudative pleural effusion were （ 151.72 ± 23.14）, （ 120.86 ± 26.92 ）, （58.09 ± 11.60）, （ 111.22 ± 34.19） kU/L, respectively, serum CA 125 of malignant pleural effusion was significantly higher than that of inflammatory pleural effusion （P 〈 0.01 ）, but the serum CA 125 level of malignant pleural effusion had no significant difference compared with that of tuberculous and transudative pleural effusion （P 〉 0.05）. The levels of CA 125 in pleural effusion of malignant, tuberculous,inflammatory and transudative pleural effusion were （3135.64 ± 1404.92）, （756.30 ±96.42）, （626.86 ± 105.55）, （814.41± 173.28） kU/L,respectively,the level of malignant pleural effusion had no significant difference compared with that of tuberculous,inflammatory and transudative pleural effusion （P 〉 0.05 ）. Conclusions The value of CA125 in the diagnosis of pleural effusion is not very significant when it is used alone. The serum CA125 combined with other tumor markers can improve the diagnosis rate of tumor. When it is applied for clinical aided diagnosis, the non specificity of CA125 should be noticed.