肿瘤标志物联合检测诊断恶性胸腔积液的应用价值

Value of tumor markers combined detection in diagnosis of malignant pleural effusion

目的探讨联合检测胸腔积液中CEA、CA15-3、CA19-9、β-HCG、TPA5种肿瘤标志物对鉴别诊断良恶性胸腔积液的价值。方法采用化学发光法检测恶性组、结核组和良性组患者胸腔积液中CEA、CA15-3、CA19-9、β-HCG、TPA的含量;并与CT和脱落细学检查进行比较,分析肿瘤标志物的诊断敏感性、特异性及其临床应用价值。结果恶性组胸腔积液中CEA、CA19-9、CA15-3、β-HCG含量明显高于结核组、良性组(P<0.01),其阳性检出率分别为:52.83%、47.17%、41.51%、43.40%;TPA在恶性组和结核组含量显著升高,明显高于良性组(P<0.01),TPA与任一项肿瘤标志物同时阳性诊断恶性胸腔积液敏感性为84.9%,特异性为87.69%,与CT和脱落细胞联合检测相当。结论胸腔积液中肿瘤标志物联合检测是CT和脱落细胞检查的有益补充,对恶性胸腔积液诊断具有良好的临床应用价值。

Objective To explore the value of the combined detection of carcino-embryonic antigen（CEA）,CA15-3,CA19-9,β-human chorionic gonadotropin（β-HCG） and tissue polypeptide antigen（TPA） in pleural fluid for the differential diagnosis of malig-nant and benign pleural effusion. Methods The value of CEA,CA15-3,CA19-9,β-HCG and TPA in the pleural fluid were assayed by chemoluminescence method. The diagnostic sensitivity and specificity were analyzed through comparing with CT and exfoliated cells examination. Results The value of CEA,CA15-3,CA19-9 and β-HCG in malignant group were significantly higher than TB group and benign group（P〈0.01） ,their positive rates were 52.83% ,47.17% ,41.51% and 43.40%. The value of TPA in malig-nant group and TB group were increased significantly compared with benign group（P〈0.01）. The sensitivity of TPA with either of other tumor markers in diagnosis of malignant pleural effusion was 84.9 %, and the specificity was 87.69%, which were similar with CT and exfoliated cells combined examinations. Conclusion These tumor markers might be useful for the diagnosis of malig- nant pleural effusion.