四项指标联合检测对胸腔积液性质的判断价值

The diagnostic value of multi-indicators detection of pleural effusion for differentiating malignant and benign pleural effusion

目的探讨癌胚抗原(CEA)、C反应蛋白(CRP)、乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)检测对胸腔积液性质的诊断价值。方法检测已经病原学或组织病理学明确诊断的胸腔积液患者180例,其中良性胸腔积液90例,恶性胸腔积液90例,检测胸腔积液中CEA、CRP、LDH、ADA含量,应用受试者工作特征曲线评价上述指标对胸腔积液性质判断的价值。结果在良性胸腔积液中,CRP、ADA水平较恶性胸腔积液患者的高,CEA、LDH较恶性胸腔积液的低(P<0.01)。良性胸腔积液组ADA和CRP的阳性率较恶性胸腔积液组高,LDH、CEA阳性率较恶性胸腔积液低(P<0.01)。根据受试者工作特征曲线,联合检测上述四项指标,可显著提高检测的敏感性和阴性预测值。结论 CEA、CRP、LDH、ADA联合检测可提高良、恶性胸腔积液的鉴别诊断价值。

Objective To investigate the diagnostic value of carcinoembryonic antigen （CEA）, C reactive protein （CRP）, lactate dehydrogenase（LDH）, adenosine deaminase （ADA） of pleural effusion for differentiating malignant and benign pleural effusion. Methods CEA, CRP, LDH, ADA in pleural effusion were detected in 90 patients with benign pleural effusion and 90 patients with malignant pleural effusion. ROC curve was used to evaluate the diagnostic sensitivity and negative predictive value of indicators above in differentiating benign and malignant pleural effusion： Results In be- nign pleural effusion, the level of CRP and ADA were higher than those in the patients with malignant pleural effusion, CEA, LDH were lower than those in the patirnts with malignant pleural effusion, the differences had significant differ- ence （P 〈 0.01）. The positive rates of CRP and ADA in benign pleural effusion group were higher than those of malig- nant pleural effusion group, the positive rates of CEA and LDH were lower compared with malignant pleural effusion, the differences had significant difference （P 〈 0.01）. When the four indicators were combined detected, the sensitivity and negative predictive value improved significantly according to ROC curve. Conclusion The combined detection of CEA, CRP, LDH, ADA can greatly improve the diagnostic value of benign and malignant pleural effusion.