多项指标检测对恶性胸腔积液的鉴别诊断价值

Many indicators value detection in the differential diagnosis of malignant pleural effusion

目的探讨胸腔积液中常规生化指标葡萄糖(GLU)、腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)检测结果在临床诊断中的应用。方法回顾分析2010年7月至2013年7月临床送检的127例胸腔积液,分为结核组、恶性肿瘤组、非结核良性组,分析3组患者中GLU、ADA、LDH、CEA、CYRFA21-1、NSE的检测结果。数据采用方差分析法进行统计分析。结果恶性组和结核组的GLU、LDH和非结核良性组比差异有统计学意义(P<0.05);恶性组和结核组的LDH和非结核良性组差异有统计学意义(P<0.01);结核组的ADA和其他2组比较差异有统计学意义(P<0.05);其他2组的CEA、NSE、CYFRA21-1和恶性组比差异有统计学意义(P<0.01)。结论联合检测胸腔积液中GLU、ADA、LDH、CEA、CYRFA21-1、NSE对胸腔积液鉴别诊断有重要的参考价值。

Objective To explore test results application of conventional biochemical indicators such as glu-cose （GLU） ,adenosine deaminase （ADA） ,lactate dehydrogenase （LDH） ,carcinoembryonic antigen （CEA） and cytokeratin 19 fragment （CYRFA21-1） and neuron specificity enolization alcohol （NSE） in clinical diagnosis for pleural effusion .Methods Clinical samples of 127 cases of pleural effusionwere reviewed from July 2010 to 2013 and divided into the TB group ,malignant tumor group and non tuberculous benign group of three groups were an-alyzed GLU ,ADA ,LDH ,CEA ,NSE ,CYRFA21-1 test results and data statistical analysis with the method of variance analysis were performed .Results Results malignant and tuberculosis group of GLU ,LDH and non tu-berculous benign group difference was statistically significant （ P ＆lt; 0.05）.Malignant and tuberculosis group of LDH and non tuberculous benign group difference was statistically significant （ P ＆lt;0.01）.Tuberculosis of ADA and the other two groups compare difference was statistically significant （ P ＆lt;0.05）.Two other groups of CEA , NSE ,CYFRA21-1 and malignant group than the difference was statistically significant （ P＆lt;0.01） .Conclusion Joint detection of GLU ,ADA ,LDH ,CEA ,NSE and CYRFA21-1 in pleural effusion and ascites for differential diagnosis of pleural effusion has important reference value .