三项肿瘤标志物检测对良恶性胸腔积液的鉴别诊断意义

Value of combined detection of three tumor markers in differential diagnosis of benign and malignant pleural effusions

目的探讨癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)检测对良恶性胸腔积液的鉴别诊断价值。方法将106例胸腔积液患者分为良性组(55例)和恶性组(51例),恶性组分为肺癌组(36例)和其它恶性肿瘤组(15例),比较各组胸腔积液CEA、CYFRA21-1、NSE水平,并比较上述三项肿瘤标志物单独检测和联合检测对良恶性胸腔积液的鉴别诊断价值。结果肺癌组和肺部其它恶性肿瘤组胸腔积液CEA、CYFRA21-1、NSE水平均高于良性组(t=16.633、11.768、11.324,P均<0.01;其它恶性肿瘤组与良性组比较,差异均有统计学意义(t=18.255、10.354、9.245,P均<0.01,肺癌组上述三项肿瘤标志物水平稍高于其它恶性肿瘤组,但差异无统计学意义(P>0.05);胸腔积液CEA、CYFRA21-1、NSE联合检测诊断肺癌和胸部其它恶性肿瘤组的敏感性和特异性均高于其中一项单独检测或两项联合检测,特异性虽然有所降低,但差异不大。结论 CEA、CYFRA21-1、NSE联合检测诊断恶性胸腔积液敏感性和准确率高,对良恶性胸腔积液的鉴别诊断具有重要意义。

Objective To investigate the value of combined detection of carcinoembryonic antigen （CEA）, cytokeratin19 fragment （CYFRA21- 1） and neuron specific enolase （NSE） in differential diagnosis of benign and malignant pleura]effusion. Methods Total 106 patients with pleural effusion were divided into the benign group （55 cases） and the malignantgroup （51 cases）, the malignant group was divided into the two groups： the lung cancer group（36 cases） and the other malignanttumor group（15 cases）. The levels CEA, CYFRA21-1, NSE of the patients were detected and compared among the differentgroups, and the detection effect was compared between comined detection and detection alone. Results The levels CEA,CYFRA21-1, NSE of malignant pleura] effusion of the lung cancer group and the other malignant tumor groups were higherthan those of the benign group, There was significant difference between the lung cancer group and the benign group（t=16.633,11.768, 11.324, P〈 0.01）.There was inginificant difference between the other mali Inant oup and the beni sroup（t=-1.255,10.354, 9.245, P〈 0.01）, however, the levels of the three tumor markers above mentioned were higher than those of the othermalignant group, the differences were no statistical significant （P〉0.05）. There was higher accuracy and specificity ofcombined detection of CEA, CYFRA21-1, NSE in diagnosis of the lung cancer of the malignant tumor groups than separatedetection, and the specificity was lower slightly but the difference was little. Conclusion It had high sensitivity accuracy andhigh accurate in diagnosis of benign and malignant pleural effusion, and it had a great significance in diagnosis of benign andmalignant pleural effusion that combined detection of CEA, CYFRA21-1 and NSE.