肿瘤标志物联合检测对恶性胸腹腔积液的诊断价值

Diagnostic value of combined detection of various tumor markers in malignant hydrothorax and hydroperitoneum

目的分析甲胎蛋白(AFP)、癌胚抗原(CEA)、糖链抗原125(CA125)、神经元特异性烯醇化酶(NSE)、糖链抗原724(CA724)联合检测对恶性胸腹腔积液的诊断价值。方法以细胞病理学诊断为金标准,采用受试者工作特征曲线(ROC曲线)确定肿瘤标志物对291例恶性胸腹腔积液的诊断临界值,以135例良性胸腹腔积液为对照,研究肿瘤标志物单独及联合检测对恶性胸腹腔积液的诊断价值。结果 ROC曲线分析结果显示,CEA、CA724诊断恶性胸腹腔积液的ROC曲线下面积均超过0.7,具有较高诊断价值。CEA、CA724、NSE、CA125单独检测时,以CEA灵敏度(81.7%)、约登指数(0.64)、阴性预测值(67.7%)、阳性预测值(90.8%)较高,特异度则以NSE(82.9%)较高。联合检测的诊断灵敏度、约登指数、阴性预测值较单独检测均有不同程度的提高。结论 CEA对恶性胸腹腔积液具有较高的诊断价值,多肿瘤标志物联合检测可提高诊断灵敏度、约登指数、阴性预测值。

Objective To explore Diagnostic value of combined detection of alpha fetoprotein（AFP）,carcino-embryonic antigen（CEA）,carbohydrate antigen 125（CA125）,neurone specific enolase（NSE）and carbohydrate antigen 724（CA724）in malignant hydrothorax and hydroperitoneum.Methods According to the pathological diagnosis as gold standard,receiver operating characteristic（ROC）curve was used to analyzed the cut-off value for the diagnosis of malignant hydrothorax and hydroperitoneum in 291 patients,and 135 patients with benign malignant hydrothorax and hydroperitoneum were enrolled as controls.Diagnostic value of single and combined detection of tumor markers was analyzed.Results Area under the ROC curve of CEA and CA724 were higher than 0.7,indicating that CEA and CA724 were with high diagnostic value.Among CEA,CA724,NSE and CA125,used for single detection,CEA was with high sensitivity（81.7%）,Jorden index（0.64）,negative predictive value（67.7%）,positive predictive value（90.8%）,and NSE（82.9%）was with high specificity.Combined detection of tumor markers could increase diagnostic sensitivity,Jorden index and negative predictive value.Conclusion CEA could be with high diagnostic value of malignant hydrothorax and hydroperitoneum.Combined detection of tumor markers could increase diagnostic sensitivity,Jorden index and negative predictive value.