胸水CEA与血清CEA比值对恶性胸腔积液的诊断价值

Diagnostic value of the ratio of CEA in pleural effusion to serum CEA in malignant pleural effusion

目的目前恶性胸腔积液确诊存在一定困难,寻找新的辅助诊断标志至关重要。本研究拟探讨胸水癌胚抗原(CEA)与血清CEA比值对恶性胸腔积液的诊断价值。方法本研究纳入南京医科大学附属南京医院呼吸与危重症医学科2017年1月1日至2018年12月31日胸腔积液患者462例,其中恶性胸腔积液174例、良性胸腔积液288例,收集临床相关数据并进行统计学分析。结果胸水CEA与血清CEA比值对恶性胸腔积液的诊断ROC曲线下面积0.918(95%CI:0.881~0.955),优于CEA ROC曲线下面积0.853(95%CI:0.804~0.902)。当胸水CEA与血清CEA比值最佳截断值为1.4时,诊断敏感性为0.85,特异性为0.84。结论胸水CEA与血清CEA比值对恶性胸腔积液具有良好的诊断价值,为临床诊断恶性胸腔积液提供新的依据。

Objective There are difficulties in making a definite diagnosis of malignant pleural effusion(MPE)and it is vital to find novel adjunctive diagnostic markers.This study intends to investigate the diagnostic value of the ratio of carcinoembryonic antigen(CEA)in pleural effusion(PE)to serum CEA in MPE.Methods A total of 462 patients with pleural effusion in Department of Respiratory and Critical Care Medicine,Nanjing Hospital Affiliated to Nanjing Medical University from January 1,2017 to December 31,2018 were included in this study,including 174 cases of MPE and 288 cases of benign pleural effusion.Related clinical data were collected and statistically analyzed.Results The results showed that the area under the Receiver Operating Characteristic(ROC)curve of the ratio of CEA in PE to serum CEA was 0.918(95%CI:0.881-0.955),which was better than that of CEA(0.853)(95%CI:0.804-0.902).When the best cutoff value of the ratio of CEA in PE to serum CEA was 1.4,the diagnostic sensitivity was 0.85 and the specificity was 0.84.Conclusion To sum up,the ratio of CEA in PE to serum CEA has a good diagnostic value for MPE,and provides a new basis for clinical diagnosis of MPE.