CEA mRNA、CEA和CA19-9检测在良、恶性胸水诊断中的应用

Diagnostic utility of detection of CEA mRNA, CEA and CA19-9 in benign and malignant hydrothorax

目的 :研究检测癌胚抗原信使核糖核酸 (CEAmRNA)、癌胚抗原 (CEA)和糖链蛋白抗原 19 9(CA19 9)水平在诊断与鉴别诊断良、恶性胸水中的应用价值。方法 :恶性胸水组 76人 ,良性胸水组 5 8人 ,采集胸水 ,应用反转录套式聚合酶链反应 (RT NP PCR)技术检测CEAmRNA ,磁分离酶免疫技术 (MAIA)检测CEA和CA19 9。结果 :CEAmRNA、CEA和CA19 9的阳性率 ,恶性胸水组分别为 78.9%(6 0 / 76 )、5 2 .6 %(4 0 / 76 )和 5 5 .3%(4 2 /76 ) ,良性胸水组分别为 8.6 %(5 / 5 8)、5 .2 %(3/ 5 8)和 3.4%(2 / 5 8) ,良、恶性胸水组各指标阳性结果的差异均具有显著性 (P <0 .0 0 1)。检测CEAmRNA、CEA和CA19 9水平诊断恶性胸水的特异性分别为 91.4%、94.8%和 96 .6 %,敏感性分别为 78 9%、5 2 6 %和 5 5 3%。三个指标联检的特异性为 90 .8%、敏感性为 82 .8%。结论 :CEAmRNA、CEA和CA19 9在恶性胸水中有较高的阳性率 ,其中以CEAmRNA指标的阳性率最高。应用CEAmRNA、CEA和CA19 9指标诊断与鉴别诊断良、恶性胸水具有较高的实用价值 ,三者联检可以进一步提高敏感性。

Purpose:To determine the diagnostic value of detection of carcinoembryonic antigen mRNA (CEA mRNA), CEA and CA19-9 for diagnosis and differential diagnosis of malignant or benign hydrothorax. Methods:The groups included 76 cases of malignant hydrothorax group and 58 cases in benign hydrothorax group from whom specimens of chest fluid were obtined. CEA mRNA was detected by reverse transcriptase-nested primer-polymerase chain reaction (RT-NP-PCR). CEA and CA19-9 were detected by magnetic antibody immunoenzymetric assay (MAIA). Results:The positive rates of CEA mRNA, CEA and CA19-9 were 78.9%(60/76), 52.6%(40/76) and 55.3%(42/76) in the malignant hydrothorax group, and 8.6% (5/58), 5.2%(3/58) and 3.4%(2/58) in the benign dropsy of chest group respectively. There were significant differences in the positive results of CEA mRNA, CEA and CA19-9 between benign and malignant hydrothorax(P<0.001). The specificities of CEA mRNA, CEA and CA19-9 to diagnose the malignant hydrothorax were 91.4%, 94.8% and 96.6%. Their sensitivities were 78.9%, 52.6% and 55.3% respectively. The specificities and the sensitivity of the combined three items were 90.8% and 82.8%.Conclusions:CEA mRNA, CEA and CA19-9 positive rates were higher in malignant hydrothorax with CEA mRNA being the highest. CEA mRNA,CEA and CA19-9 are very helpful in the diagnosis and differential diagnosis of benign or malignant hydrothorax. The combination of the three items can enhance the sensitivity further.