胸水及血清CEA、CA153、CA125、CA199检测在胸腔积液诊断中的应用

The clinical value of pleural fluid measuring and serum CEA,CA153,CA125,CA199 measuring in the diagnosis of pleural effusion

目的探讨胸水及血清癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原153(Carbohydrate antigen 153,CA153)、糖类抗原125(CA125)、糖类抗原199(CA199)检测在胸腔积液诊断中的价值。方法采用免疫电化学发光法分别检测64例胸腔积液患者胸水与血清中的CEA、CA153、CA125、CA199浓度;绘制ROC曲线判断恶性胸腔积液诊断的最佳临界值,对胸水、血清中四种肿瘤标记物的单项或联合检测进行平行试验及序列试验分析。结果恶性组胸水、血清中四种肿瘤标记物浓度均大于良性组(P<0.05或P<0.01);CEA、CA153、CA199单项检测良、恶性鉴别诊断的特异度高、敏感度偏差,CA125单项检测正好相反;以单项检测的临界值为标准,胸水、血清四种肿瘤标志物联合检测的敏感度、特异度、Youden指数均高于单项指标检测。结论四种肿瘤标记物联合检测在胸腔积液诊断及鉴别诊断中可起到良好的互补作用,比单一指标检测诊断的敏感性、特异性高。

Objective To explore the value of CEA, CA153, CA125, CA199 detection in pleural fluid and serum in the diagnosis of pleural effusion. Method Use Immunohistochemieal electroehemiluminescence to detected CEA, CA153, CA125 ,CA199 concentration in pleural fluid and serum of 64 cases of pleural effusion; draw IROC curve to determine the malignant optimal threshold in the diagnosis of pleural effusion, parallel test and sequence analysis of single or joint detection test for four tumor markers. Findings Four tumor markers in pleural effusion, serum of malignant were higher than in the benign group（ P 〈0.05 or P 〈 0.01 ） ;CEA ,CA153, CA199 single detection of benign and malignant differential diagnosis with high specificity, sensitivity deviation, CA125 single detection opposite; to single detection threshold is standard, pleural effusion, the sensitivity of serum tumor markers in four joint detection, specificity, Youden index were higher than the detection of individual indicators. Conclusion Pleural fluid and serum CEA, CA153, CA125, CA199 combined detection can play a complementary role in a good diagnosis and differential diagnosis of pleural effusion, and pleural effusion or serum than just detect these indicators diagnostic sensitivity, high specificity.