ADA、CEA、CA153及CA125在胸腔积液诊断中的价值

Value of combined detection of ADA,CEA,CA153 and CA125in the diagnosis of pleural effusion

目的:研究腺苷脱氨酶(ADA)、癌胚抗原(CEA)、糖链抗原153(CA153)及糖链抗原125(CA125)在胸腔积液中的表达情况,探讨其在胸腔积液中的诊断价值。方法:选择2011年1月～2013年1月资料完整、诊断明确的120例胸腔积液住院患者,根据病因的不同分为恶性胸腔积液组44例,结核性胸腔积液组52例和其他病因胸腔积液组24例,并选择同期健康体检者30例作为对照组,检测所有入组人员血清中腺苷脱氨酶(ADA)、癌胚抗原(CEA)、糖链抗原153(CA153)及糖链抗原(CA125)水平。结果:恶性胸腔积液组CEA及CA153明显高于结核性胸腔积液组和健康对照组(P<0.05),结核性胸腔积液组ADA明显高于恶性胸腔积液组和健康对照组(P<0.05),CA125水平三组间比较差异无统计学意义(P>0.05)。以CEA>10ng/mL、CA153>25U/mL及ADA<35U/L作为阳性参考值诊断为恶性胸腔积的敏感度为92.7%,特异度为96.3%。结论:CEA及CA153水平在恶性胸腔积液患者中显著升高,ADA在结核性胸腔积液患者中显著升高而在恶性胸腔积液患者中无显著变化,联合三组检测可提高鉴别恶性胸腔积液诊断的敏感度和特异度。

Objective：To study expression of ADA,CEA,CA153and CA125in pleural effusion,and to explore its value in diagnosis of in pleural effusion.Methods：A total of 120cases of pleural effusion that were admitted to our hospital during January 2011and January 2013were selected,including 44cases of malignant disease,52cases of tuberculosis,24cases of pleural effusion caused by other reason.Thirty cases of healthy people were also enrolled as control group.ADA,CEA,CA153and CA125levels were detected and analyzed in all groups.Results：CEA,CA153levels of the malignant disease group were significantly higher than the tuberculosis group and the healthy control group（P0.05）.ADA level of the tuberculosis group was significantly higher than the malignant disease group and the control group.CA125 level of the three groups were not significantly different（P0.05）.Using CEA10ng/mL、CA15325 U/mL and ADA35U/L as criteria,the sensitivity and specificity of diagnosing malignant disease was 92.7% and 96.3%,respectively.Conclusion：CEA and CA153levels significantly increase in malignant pleural effusion cases,ADA level increase obviously in tuberculosis pleural effusion but not in malignant cases indicating combined detection the three can raise the sensitivity and specificity in diagnosis of malignant pleural effusion.