联合检测肿瘤标志物对良恶性胸腔积液的诊断价值

Diagnostic value of combined detection of tumor markers for benign and malignant pleural effusion

目的:探讨联合检测肿瘤标志物ProGRP、CEA、CYFRA21-1、NSE、SCC对良恶性胸腔积液的诊断价值。方法:收集2020年1月-2021年1月在包头医学院第一附属医院收治的确诊为良性胸腔积液(BPE,87例)和恶性胸腔积液(MPE,44例)患者,共131例。应用化学发光法检测患者胸腔积液中ProGRP、CEA、CYFRA21-1、NSE以及SCC的浓度,比较良恶性胸腔积液中肿瘤标志物的水平,将5种肿瘤标志物以不同的方式组合,通过受试者工作特征(ROC)曲线分析比较不同联合方式的诊断价值。结果:ProGRP+CEA+CYFRA21-1+NSE联合方式对应的ROC曲线下面积(AUC)最大(0.841),其约登指数最大时,灵敏度77.3%,特异度85.1%,阳性似然比5.188,阴性似然比0.267,诊断价值最高。结论:通过联合检测不同组合的肿瘤标志物发现,ProGRP+CEA+CYFRA21-1+NSE的组合形式在诊断效能、特异度、灵敏度、阳性似然比、阴性似然比等方面优于其他组合,在鉴别诊断胸腔积液性质方面有重要参考价值。

Objective:To investigate the diagnostic value of combined detection of tumor markers ProGRP,CEA,CYFRA21-1,NSE and SCC in the diagnosis of benign and malignant pleural effusion.Methods:A total of 131 cases of pleural effusion diagnosed as benign pleural effusion and malignant pleural effusion in the First Affiliated Hospital of Baotou Medical College from January 2020 to January 2021 were collected,including 87 cases of BPE and 44 cases of MPE.The concentrations of ProGRP,CEA,CYFRA21-1,NSE and SCC in pleural effusion of patients were detected by chemiluminescence method,and the levels of tumor markers in benign and malignant pleural effusion were compared.Five tumor markers were combined in different ways,and the diagnostic values of different combinations were compared by receiver operating characteristic(ROC)curve analysis.Results:The area under the ROC curve(AUC)corresponding to the combination of ProGRP+CEA+CYFRA21-1+NSE was the largest(0.841),and the sensitivity was 77.3%,the specificity was 85.1%,the positive likelihood ratio was 5.188,and the negative likelihood ratio was 0.267,with the highest diagnostic value.Conclusion:The combination of ProGRP+CEA+CYFRA21-1+NSE is superior to other combinations in terms of diagnostic efficacy,specificity,sensitivity,positive likelihood ratio and negative likelihood ratio,and has important reference value in the differential diagnosis of pleural effusion.