联合检测血清和胸腔积液Crk样蛋白、CEA在恶性胸腔积液诊断中的价值

Diagnostic value of serum, pleural effusion Crk-like protein and CEA in malignant pleural effusion

目的评价联合检测血清和胸腔积液中Crk样蛋白(CRKL)、癌胚抗原(CEA)对恶性胸腔积液的诊断价值。方法采用酶联免疫吸附法(ELISA)检测47例恶性胸腔积液和46例良性胸腔积液患者的血清和胸腔积液CRKL、CEA水平。结果恶性胸腔积液组血清CRKL显著高于良性胸腔积液组(P<0.001),恶性胸腔积液组胸腔积液CRKL浓度显著高于良性胸腔积液组(P<0.001);恶性胸腔积液组血清CEA显著高于良性胸腔积液组(P<0.001),恶性胸腔积液组胸腔积液CEA浓度显著高于良性胸腔积液组(P<0.001)。ROC曲线分析得血清及胸腔积液CRKL临界值分别为2.04ng/mL、3.04ng/mL,其敏感度分别为80.9%、74.5%;特异性分别为80.4%、84.8%。联合检测血清及胸腔积液CRKL的灵敏度为80.9%,特异性为80.4%;联合检测胸腔积液CRKL及CEA的灵敏度为89.4%,特异性为95.7%;联合检测四者的灵敏度为87.2%,特异性为97.8%。结论血清和胸腔积液中CRKL可作为鉴定良恶性疾病的重要辅助指标;胸腔积液CRKL联合胸腔积液CEA检测可提高恶性胸腔积液的诊断价值。

Objective To evaluate the diagnostic value of combined detection of Crk-like protein(CRKL) and carcinoembryonic antigen(CEA) in serum and pleural effusion for malignant pleural effusion. Methods Chemiluminescence immunoassay(ELISA) was used to detect CRKL and CEA levels in serum and pleural fluid signal junction proteins in 47 patients with malignant pleural effusion and 46 patients with benign pleural effusion. The efficacy of signal junction proteins CRKL and CEA in diagnosing malignant pleural effusion in serum and pleural effusion was evaluated. Results Serum CRKL in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group(P<0.001), and CRKL in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group(P<0.001). Serum CEA in the malignant pleural effusion group was significantly higher than that in the benign pleural effusion group(P<0.001), and CEA concentration in themalignant pleural effusion group was significantly higher than that in the benign pleural effusion group( P < 0. 001).The CRKL thresholds of serum and pleural effusion were 2. 04 ng/mL and 3. 04 ng/mL,respectively,and the sensitivity was 80. 9% and 74. 5%,respectively. The specificity was 80. 4% and 84. 8%,respectively. The sensitivity and specificity of CRKL in serum and pleural effusion were 80. 9% and 80. 4% respectively. The sensitivity and specificity of the combined detection of CRKL and CEA in pleural effusion were 95. 9% and 89. 4%,respectively. The sensitivity and specificity of the combined test were 96. 3% and 89. 4% respectively. Conclusion CRKL in serum and pleural effusion can be used as an important auxiliary index to identify benign and malignant diseases. The detection of pleural effusion CRKL combined with CEA of pleural effusion can improve the diagnostic value of malignant pleural effusion.