CEA、CYFRA21-1、NSE、SF联检鉴别癌性与结核性胸水

Combined Detection of CEA, CYFRA21-1, NSE and SF Levels in Chest Effusion Fluid for Differentiation of Malignant Hydrothorax from Tuberculous Hydrothorax

目的 :通过对胸水多项肿瘤标志物联合检测来鉴别癌性与结核性胸水 ,以提高癌性胸水诊断的阳性率。方法 :用放射免疫分析和化学发光法测定 6 9例 (男 4 7,女 2 2 )结核性胸水、10 7例 (男 83,女 2 4 )癌性胸水CEA、CYFRA2 1- 1、NSE、SF水平 ,两组间进行比较。结果 :癌性胸水组四项肿瘤标志物均值及阳性率均显著高于结核性胸水组 (p均 <0 0 1)。四项指标联检对癌性胸水诊断的阳性率为 95 33%。结论 :胸水CEA、CYFRA2 1- 1、NSE、SF水平检测对鉴别癌性胸水与结核性胸水有重要价值 ,四项指标联合检测可显著提高癌性胸水的阳性诊断率。

Objective To improve the diagnostic accuracy in the differentiation of malignant hydrothorax from tuberculous hydrothorax by combined detection of the levels of the four tumor markers in chest effusion fluid. Methods The chest fluid levels of the four tumor markers were determined with RIA (for CYFRA21-1 and NSE) and chemiluminescence method (for CEA and SF) in 69 patients with tuberculous hydrothorax and 107 patients with malignant hydrothorax. Results The positive rate and mean levels of the four tumor markers in malignant chest fluid were significantly higher than those in tuberculous chest fluid ( p <0 01). Positive rate of combined detection in malignant chest fluid was 95 33%. Conclusion Detection of chest fluid CEA, CYFRA21-1, NSE and SF levels is very useful for the differentiation of malignant hydrothorax from tuberculous hydrothorax. Combined detection of the four markers will greatly improve the diagnostic accuracy.