检测CEA-mRNA、CEA和CA19-9诊断恶性胸水的应用价值

A study on the applied value in detection of carcinoembryonic antigen mRNA?CEA and CA19-9 for diagnosis of malignant dropsy of chest

目的 评估检测癌胚抗原信使核糖核酸 (CEA mRNA)、CEA和CA19 9指标在诊断与鉴别诊断恶性胸水方面的应用价值。方法 研究对象包括恶性胸水组 5 8例、良性胸水组 5 8例 ,采集胸水为检测标本 ,应用磁酶免技术(MAIA)检测CEA和CA19 9、反转录套式聚合酶链反应 (RT NP PCR)技术检测CEA mRNA。结果 恶性胸水组 ,CEA mRNA、CEA和CA19 9的阳性率分别为 79.3 % (4 6/ 5 8)、5 1.7% (3 0 / 5 8)和 5 5 .2 % (3 2 / 5 8) ;良性胸水组 ,CEA mRNA、CEA和CA19 9的阳性率分别为 8.6% (5 / 5 8)、5 .2 % (3 / 5 8)和 3 .4% (2 / 5 8)。检测胸水标本CEA mRNA、CEA和CA19 9指标诊断恶性胸水的特异性分别为 91.4%、94.8%和 96.6% ,敏感性分别为 79.3 %、5 1.7%和 5 5 .2 %。三个指标联检的敏感性为 87.9% (5 1/ 5 8)。结论 在诊断恶性胸水方面 ,CEA mRNA、CEA和CA19 9指标的特异性和敏感性均较高 ,但CEA mRNA指标的敏感性显著性高于CEA和CA19 9指标 (P <0 .0 1) ,三者联检可以进一步提高敏感性。

ObjectiveTo study the applied value on detection of carcinoembryonic antigen mRNA(CEA-mRNA),CEA and CA19-9 for diagnosis and differential diagnosis of malignant dropsy of chest.MethodsThe objects of the study consisted of 58 patients with malignant dropsy of chest and 58 patients with benign dropsy of chest.CEA-mRNA was detected by reverse transcriptase-nested-primer-polymerase chain reaction(RT-NP-PCR),CEA by enzyme-linked immunosorbent assay(ELISA) and CA19-9 by magnetic antibody immunoenzymetric assay(MAIA).ResultsIn the malignant dropsy of chest group,the positive rates of CEA-mRNA,CEA and CA19-9 were 46(79.3%),30(51.7%),and 32(55.2%) respectively. In the benign dropsy of chest group,the positive rates of CEA-mRNA,CEA and CA19-9 were 5(8.6%),3(5.2%) and 2(3.4%).In the diagnosis of malignant dropsy of chest,the specificity was 91.4% to CEA-mRNA, 51.7% to CEA and 55.2% to CA19-9.The sensitivity was 87.9(51/58) when combined detection of CEA-mRNA and CEA and CA19-9 was used.ConclusionCEA-mRNA,CEA and CA19-9 are useful indexes for diagnosis and differential diagnosis of malignant dropsy of chest.The sensitivity of CEA-mRNA is higher than that of CEA and CA19-9(P<0.01).The sensitivity can be improved when combined detection of CEA mRNA and CEA and CA19-9 is conducted.