细胞形态计量学联合肿瘤标志物检测对恶性胸腹水诊断价值的探讨

Diagnostic value of combined detection of cell morphometry and tumor maker in malignant pleural effusion and ascites

目的探讨细胞形态计量学、肿瘤标志物检测对恶性胸腹水诊断的价值。方法选取90例胸腹水患者,细胞形态计量学检测胸腹水细胞形态,根据形态学计量结果级别进行积分,计算总积分,同时免疫化学发光法检测胸腹水肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19片段(CYFRA21-1)。结果根据临床诊断结果分为疾病组和对照组,疾病组与对照组细胞形态总积分差异有统计学意义,细胞形态计量学对恶性胸腹水诊断的敏感度、特异度和正确率分别为86.67%、96.67%、93.33%,5项肿瘤标志物中CEA对恶性胸腹水诊断的敏感度、特异度和正确率分别为90.00%、90.00%、90.00%。细胞形态计量学联合CEA对恶性胸腹水的敏感度、特异度和正确率分别为90.00%、96.67%、94.44%。结论细胞形态计量学对恶性胸腹水的诊断有重要价值,细胞形态计量学联合CEA检测可提高恶性胸腹水的诊断效能。

Objective To evaluate the diagnostic value of combined detection of cell morphometry and tumor maker in malignant pleural effusion and ascites. Methods Ninety patients with pleural effusion and ascites were selected,and the morphology of pleural effusion and ascites cells was detected by cell morphometry. The scores were recorded and added up according to the morphometric scores. While CEA,CA125,CA19-9,NSE and CYFRA21-1 were measured by chemiluminescence immunoassay. Results The patients were divided into the case group and the control group according to the clinical diagnosis results.There was statistical significance on the difference in the total points of cytomorphological parameters between the two groups.The sensitivity,specificity and accuracy of cell morphometry and tumor maker（ CEA） were 86. 67%,96. 67%,93. 33%,90. 00%,90. 00%,90. 00% for predicting the benign or malignant pleural effusion and ascites,respectively. And that were90. 00%,96. 67%,94. 44% of the combined detection of cell morphometry and tumor maker（ CEA）. Conclusion Cell morphometry has important value in the diagnosis of malignant pleural effusion and ascites. Cell morphometry combined with tumor marker（ CEA） detection can improve the efficacy of malignant serous effusions.