心钠素、癌胚抗原及铁蛋白联合测定对良、恶性胸腔积液的鉴别价值

Evaluation of atrial natriuretic peptide,carcinocmbryonic antigen,ferritin in differentiating benign and malignant pleural effusion

为探讨心钠素 ( ANP)、癌胚抗原 ( CEA)、铁蛋白 ( Ft)水平在良、恶性胸腔积液 (简称胸液 )中的鉴别价值 ,采用放射免疫直接测定法测定了 3 8例结核性胸液和 64例恶性胸液患者的胸液及血清 ANP,CEA、Ft水平 ,并计算其胸液 /血清 ( P/ S)值。结果显示 ,血清 ANP水平结核组、恶性组与对照组无显著差异 ( P>0 .0 5 ) ;血清 CEA、Ft水平恶性组显著高于结核组和对照组 ( P<0 .0 1)。胸液 ANP、CEA、Ft水平恶性组均显著高于结核组 ( P均 <0 .0 0 1)。ANP、CEA、Ft之 P/ S值恶性组均高于结核组 ( P<0 .0 0 1) ,其中结核组 ANP水平胸液低于血清 ( P<0 .0 1) ,恶性组CEA、Ft水平胸液高于血清 ( P<0 .0 1)。联合检测胸液 ANP、CEA、Ft水平对恶性胸液诊断的敏感性和特异性分别为95 .3 %和 10 0 % ,若采用 ANP、CEA、Ft之 P/ S值诊断恶性胸液 ,可使其敏感性提高至 96.6%。认为联合检测胸液 ,血清中的 ANP、CEA、Ft水平并计算 P/ S值 ,对良、恶性胸液的鉴别诊断具有重要临床价值。

To stady the value of atrial natriuretic peptide(ANP),carcinocmbryonic antigcn(CEA),fcrritin(Ft)in dffcrcntiating bcnign and malignant pleural effusion Direct radioimmunoassay was used to detect ANP,CEA,Ft of plcural offusion and sorum in 38 tubcrculous and 64 maligant plcural effusion patients,and also countcd plcural offusion/scrum(P/S)value scparat ively Results shawed that the serum ANP in tuberculous and malignant pleural effusion compared with conirol group,there was no statistical difference(P>0 05) The serum CEA,Ft of malignant group were higher than that of tuberculous and control gruop,the difference was remarkable(P<0 01) The ANP,CEA,Ft of pleural effusion of malignant group were higher than that of tuberculous group,the difference was remarkable(P<0 001) The ratio of ANP,CEA,Ft of pleural effusion to that of serum were higher in malignant group than that of tuberculous one,the difference was remarkable(P<0 001) The ANP of tuberculous plerual effusion was apparently lower than serum,and significant difference was found(P<0 01) The CEA,Ft of malignant pleural effusion were higher than serum,and significant difference was also found(P<0 01) Combincd dctootiom of ANP,CEA,Ft of plcural offusion was used,and the sensitivity was 95 3% and spectificity 100% in diagnosing malignant pleural effusion,as well as P/S valuc of ANP,CEA,Ft were vounted in diagnosing malignant pleural effusin,and the sensitivity was elevated to 96 6% This suggest combined detection of ANP,CEA,Ft both in pleural effusion and serum,and also counted P/S value is significant clinical value for differentiating bcnign and malignant pleural offusion