联合检测D-二聚体和癌胚抗原对恶性胸腔积液的诊断价值

Diagnostic value of D-Dimer and carcinoembryonic antigen for malignant pleural effusion

目的评估D-二聚体(D-Dimer)和癌胚抗原(CEA)对恶性胸腔积液的诊断价值。方法收集78例恶性胸腔积液患者和64例良性胸腔积液患者的胸腔积液标本,检测胸腔积液中的D-Dimer和CEA水平。结果恶性胸腔积液中D-Dimer和CEA的表达水平均显著高于良性胸腔积液[D-Dimer:(24.35±8.10)比(13.72±6.48)mg/L,P<0.05;CEA:(41.86±21.66)比(13.36±6.88)ng/mL,P<0.05]。选定18.5 mg/L作为D-Dimer的临界值,其诊断恶性胸腔积液的敏感度为76.92%,特异度为82.81%,准确度为80.00%;选定24.5 ng/mL作为CEA的临界值,其诊断恶性胸腔积液的敏感度为79.49%,特异度为92.19%,准确度为85.00%。二者联合检测诊断恶性胸腔积液的敏感度为89.74%,特异度为75.00%,准确度为90.00%。结论恶性胸腔积液中D-Dimer水平显著高于良性胸腔积液,并对恶性胸腔积液具有较高的诊断价值,联合检测D-Dimer和CEA可提高对恶性胸腔积液的诊断准确性。

Objective To evaluate the diagnostic value of D-Dimer and carcinoembryonic antigen （CEA） for malignant pleural effusion. Methods Pleural effusion specimens were collected from 78 patients with malignant pleural effusion and 64 patients with benign pleural effusion. The concentration of pleura[ D-Dimer and CEA were detected. Results The concentration of D-Dimer and CEA were higher in malignant pleural effusion compared to benign pleural effusion [D-Dimer：（24.35±8.10）vs（13.72±6.48）mg/L,P〈0.05;CEA：（41.86±21.66）vs（13.36±6.88）ng/mL,P〈0.05]. With a threshold value of 18.5 mg/L, the sensitivity, specificity and diagnostic accuracy for D-Dimer in the diagnosis of malignant pleural effusion were 76.92%, 82.81% and 80.00%. With a threshold value of 24.5 ng/mL, the sensitivity, specificity and diagnostic accuracy for CEA in the diagnosis of malignant pleural effusion were 79.49%, 92.19% and 85.00%. When combined together, the sensitivity, specificity, and diagnostic accuracy were 89.74%, 75.00% and 90.00%. Conclusion The concentration of D-Dimer is higher in malignant pleural effusions compared to benign pleural effusions. Detection of D-direct plays a role in the diagnosis of malignant pleural effusion. The combination of D-Dimer and CEA may increase the diagnostic accuracy for malignant pleural effusion.