胸水CA50、唾液酸、癌胚抗原、铁蛋白及白介素-8检测对鉴别良、恶性胸水的价值

Role of combination of CA50、TSA、CEA、SF and IL-8 assays in differentiation of benign from malignant pleural effusion

目的 :评价胸水糖链抗原 50 (CA50 )、唾液酸 (TSA)、癌胚抗原 (CEA)、铁蛋白 (SF)及白细胞介素 - 8(IL - 8)对鉴别良、恶性胸水的价值。方法 :结核性胸膜炎组 (A组 )患者 40例 ,恶性胸水组 (B组 ) 34例 ,均经临床及病理证实。采用放免法测定胸水CEA、CA50、SF ;采用Joudian氏法测定胸水TSA ;采用酶联免疫双抗体夹心法检测胸水IL - 8,比较A、B两组胸水测定值差异及各项测定的灵敏度、特异性及五项联检、CEA +CA50检测的灵敏度及特异性。结果 :B组五项检测值均与A组存在显著差异 (P <0 0 1及 0 0 0 1 ) ,五项联检灵敏度提高到 88% ,与单项检测相比差异显著 (P <0 0 5) ,特异性为 77% ,较CA50 +CEA显著降低 (P <0 0 5)。CEA +CA50联检特异性为 95 % ,灵敏度为 79% ,较CA50、TSA、CEA、SF、IL - 8、CEA单项检查增高 (P <0 0 5)。结论 :胸水CA50、TSA、CEA、SF及IL - 8测定对鉴别良、恶性胸水有重要意义 ,上述五项联检可有效降低恶性胸水漏诊率 ,胸水CA50

Objective:To evaluate the role of detecting pleural level of CA50、TSA、CEA、SF and IL-8 in differentiation of benign from malignant pleural effusion.Methods:40 patients and 34 patients with tuberculous pleuritis (group A) and malignant pleurisy (group B) were detected.The pleural level of CA50、TSA、CEA、SF and IL-8 were with immunoradiometric assay and jourdian′s method.Then we compared the difference of the level of markers detected above,and estimated the positive rate and specific markers above.Results:The pleural CA50、TSA、CEA、SF and IL-8 values in group B were significantly higher than those in group A(P<0 001 and P<0 01).Using a combination of the CA50、TSA、CEA、SF and IL-8 assays,the sensitivity for malignant effusions was increased to 88%,but the specificity was 77%.It was significantly lower than that of CA50+CEA.The specificity of pleural CEA in combination with CA50,assays was increased to 79%.The positive rate of combination assay of 5 markers was significantly higher than single marker (P<0 05).Conclusions:The results suggest that determination of pleural CA50、TSA、CEA、SF and IL-8 are better for the differentiation of benign from malignant pleural effusion.The misdiagnosis rate of combination assay of 5 markers may produce a significant decrease in patients with malignant pleural effusion.Pleural CEA in combination with CA50 assay may be a better indicator for screening the malignant pleural effusion.