血清糖类抗原125和糖类抗原19-9及癌胚抗原在结核性胸膜炎中的诊断价值

Diagnostic values of serum CA125, CA19-9 and CEA in tuberculous pleurisy

目的探讨血清糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)在结核性胸膜炎中的诊断价值。方法选择2016年6月—2018年10月本院收治的经病理检查确诊为结核性胸膜炎患者60例为病例组,另选取同期到本院行健康体检的健康者60人作为对照组。测定2组血清CA125、CA19-9、CEA水平,比较各项指标及联合诊断结核性胸膜炎的价值。结果病例组血清CA125为(168.52±20.34)U/mL、CA19-9为(204.15±16.85)U/mL、CEA为(50.27±9.65)ng/mL,均高于对照组[(29.02±4.41)U/mL、(25.84±3.52)U/mL、(4.21±2.01)ng/mL],差异均有统计学意义(P值均<0.05);血清CA125诊断灵敏度为83.33%、特异度为75.00%、准确度为79.17%、ROC曲线下面积(AUC)为0.782,血清CA19-9分别为80.00%、78.33%、79.17%、0.773,血清CEA分别为85.00%、76.67%、80.83%、0.805;3项指标联合诊断灵敏度为96.67%、特异度为73.33%、准确度为85.00%、AUC为0.883,3项指标联合诊断灵敏度高于各项指标,(P值均<0.05)。结论血清CA125、CA19-9、CEA联合检测可提升结核性胸膜炎诊断灵敏度,为临床诊治结核性胸膜炎提供重要依据。

Objective To study the diagnostic values of serum carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9) and carcinoembryonic antigen(CEA) in tuberculous pleurisy.Methods A total of 60 patients who were definitely diagnosed as tuberculous pleurisy by pathological examinations were selected as the tuberculous pleurisy case group from June 2016 to October 2018,and 60 healthy persons who took part in physical examinations in a hospital were selected as the control group during the same period.The levels of CA125,CA19-9 and CEA in two groups were measured,and compared.Results The serum CA125 [(2552±20.34) U/mL],CA19-9 [(204.15±16.85) U/mL],and CEA[(50.27±9.65) ng/mL] in the case group were higher than those in the control group [(29.02±4.41) U/mL,(25.84±3.52) U/mL,and(4.21±2.01) ng/mL],and the difference was statistically significant(P <0.05).The diagnostic sensitivity of serum CA125 was 83.33%,the specificity was 75.00%,the accuracy was 79.17%,and the area under curve(AUC) of receiver operating characteristic curve(ROC) was 0.782;the diagnostic sensitivity,specificity,accuracy,and AUC of serum CA19-9 were80.00%,78.33%,79.17%,and 0.773%;the diagnostic sensitivity,specificity,accuracy,and AUC of serum CEA was85.00%,76.67%,80.83%,and 0.805;the sensitivity,specificity,accuracy,and AUC of the three indexes were 96.67 %,73.33%,85.00%,and 0.883,respectively.The sensitivity of the combined diagnosis of the three indexes was higher than that of each index alone,and the difference was statistically significant(P <0.05).Conclusion The combined detections of serum CA125,CA19-9,and CEA can improve the diagnostic sensitivity of tuberculous pleurisy,so as to provide an important basis for clinical diagnosis and treatment of tuberculous pleurisy.