肿瘤标志物CEA、CA125、CA199在恶性胸腔积液鉴别中的应用分析

Application analysis of tumor markers CEA,CA125,CA199 in differential diagnosis of malignant pleural effusions

目的探究良恶性胸腔积液中血清及胸腔积液癌胚抗原(CEA)、糖类抗原125(CA125)及糖类抗原199(CA199)水平差异,并为临床诊断积累实践性经验。方法回顾性分析该院于2010年2月至2014年3月收治的125例胸腔积液患者,根据积液性质划分为良性组(49例)及恶性组(76例)。记录两组胸腔积液病因构成、胸腔积液及血清肿瘤标志物水平,同时计算胸腔积液中的肿瘤标志物诊断效能。结果胸腔积液CEA、CA125、CA199联合检测对良、恶性胸腔积液的诊断特异度90.6%、灵敏度95.1%、阳性预测值90.2%、阴性预测值95.3%及准确度92.7%,均高于单独检测各项肿瘤标记物及任意2项标志物联合诊断。结论胸腔积液中CEA、CA125及CA199三项指标联合诊断,有利于良、恶性胸腔积液的辅助诊断。

Objective To explore the difference of serum and pleural effusion CEA ,CA125 and CA199 levels in benign and ma‐lignant pleural effusions to accumulate the practical experience for clinical diagnosis .Methods 125 patients with pleural effusion in this hospital from February 2010 to March 2014 were performed the retrospective analysis and divided into the benign group（49 ca‐ses） and malignant group（76 cases） according to the nature of the fluids .The etiology composition ,pleural effusion and serum tumor markers levels were recorded in the two groups and at the same time the diagnosis efficiency of the tumor markers in pleural effusion was calculated .Results The specificity of the combined detection of CEA ,CA125 and CA199 for diagnosing benign and malignant pleural effusion was 90 .6% ,the sensitivity was 95 .1% ,the positive predictive value was 90 .2% ,negative predictive val‐ue was 95 .3% and accuracy was 92 .7% ,which were higher than those of the single index detection and any 2‐marker combined de‐tection .Conclusion The combined diagnosis of CEA ,CA125 and CA199 in pleural effusion conduces to the assisted diagnosis of be‐nign and malignant pleural effusion .