肿瘤标志物及生化指标联合检测在良恶性胸腹腔积液诊断中的价值

The Value of Combined Detection of Tumor Markers and Biochemical Parameters in Diagnosis of Benign and Malignant Pleural Effusion and Seroperitoneum

目的探讨肿瘤标志物及生化指标联合检测在良恶性胸腹腔积液诊断中的价值。方法选择本院2010年以来住院且已确诊为良恶性胸腹腔积液的患者共160例,其中包括恶性80例,良性80例。对患者胸腹腔积液进行癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原125(CA125)、糖类抗原199(CA199)、腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、总蛋白(TP)、葡萄糖(GLU)、总胆固醇(TCH)、铁蛋白(FT)等10项指标检测,并根据结果分析各指标对诊断良恶性胸腹腔积液的价值。结果恶性胸腹腔积液组CEA、AFP、CA125、CA199、FT指标均显著高于良性胸腹腔积液组,差异有统计学意义(P<0.01),而生化指标中恶性胸腹腔积液组ADA、LDH、TP、GLU各指标均显著高于良性胸腹腔积液组(P<0.01),联合上述指标对恶性胸腹腔积液诊断的敏感性为91.25%,特异性为76.25%,准确性为83.75%。结论联合检测肿瘤标志物及生化指标可提高良性和恶性胸腹腔积液鉴别诊断的准确性和灵敏性,可明显提高临床诊断和鉴别能力。

Objective To explore the value of the combined detection of tumor markers and biochemical parameters on the diagnosis of pleural effusion and seroperitoneum both benign and malignant. Methods The level of CEA, AFP, CA125, CA199,ADA,LDH,TP,GLU and TCH,KF in the 160 cases of pleural effusion and seroperitoneum both benign and malignant were detected,including 80 patients diagnosed with malignant pleural effusion and seroperitoneum,80cases of benign pleura[ effu- sion and seroperitoneum. And The sensitivity and specificity of each index and the combination of them on the diagnostic efficien- cy were analyzed. Results The level of the CEA, CEA,AFP, CAI25, CA199 and FT in malignant pleural effusion and seroperito- neum group were significantly higher than that of the benign group（ P 〈0.01 ） ,and level of the biochemical parameters including ADA ,LDH ,TP and GLU were significantly higher than that of the benign effusion group（ P 〈0.01 ） ;When the combination of in- dex was used in the diagnosis of malignant pleural effusion and seroperitoneum, the diagnostic sensitivity was 91.25 % , specificity was 76.25% , and the diagnostic accuracy was 83.75 %. Conclusion The combined detection of tumor markers and biochemical parameters can be used for differential diagnosis on the pleural effusion and seroperitoneum both benign and malignant, and obvi- ously elevate the diagnostic accuracy and sensibility.