CEA、CA125、CA50在结核及肺癌性胸水鉴别中的意义

Differential diagnosis of tuberculosis and lung cancer pleural effusion by CEA,CA125,CA50

目的:探讨癌胚抗原(CEA)、糖类抗原(CA125)、糖类抗原(CA50)在胸水鉴别诊断中的意义。方法:收集已明确胸水性质的标本126例(结核性70例、癌性56例),检测胸水中CEA、CA125、CA50的数值,进行统计分析。结果:肺癌性胸水中CEA、CA50表达水平及敏感度明显高于结核性胸腔积液(P<0.05),特异性分别为95.71%和98.57%。同样CA125在肺癌性胸水中高表达(P<0.05),但两组敏感度无差异(P>0.05),特异性仅为5.71%;CEA和CA125联合诊断肺癌性胸水的敏感度为92.11%,CA125和CA50联合诊断敏感度为95.24%。CEA>10ng/ml或CA125>2000U/ml,可初步定为肺癌性胸水。结论:CEA、CA125、CA50单独或联合检测对鉴别诊断结核及肺癌性胸水有重要临床指导意义。

Objective ：To explore the significance of differential diagnosis of pleural effusion by detection of carcinoembryonic antigen （CEA）, carbohydrate antigen （CA125） and carbohydrate antigen （CAS0）. Methods：A total of 126 specimens from pleural effusion diagnosed as TB in 70 cases and lung cancer in 56 cases were collected. CEA, CA125, CA50 in the pleural effusion were analyzed. Results ：The expression level and sensitivity of CEA and CAS0 in pleural effusion of lung cancer was significantly higher than that in tuberculous （ P 〈 0.05 ）. The specificity was re- spectively 95.71% and 98.57%. CA125 in pleural effusion of lung cancer was also highly expressed （P 〈 0.05 ）. However, there was no significant difference in the sensitivity between the two groups （ P 〉 0.05 ）. The specificity was only 5.71%. Combining CEA with CA125 to diagnose pleural effusion resulted fore lung cancer, the sensitivity was 92.11% and combining CA125 with CA50 the sensitivity was 95.24%. When the concetration of CEA was more than 10ng/ml or the concetration of CA125 was more than 2000U/ml, pleural effusion of lung cancer should be highly suspected. Conclusion：The use of CEA, CA125 and CAS0 separately, or in combination is helpful to differential diagnosis of pleural effusion resulted from tuberculosis and lung cancer.