摘要
目的探讨腺苷脱氨酶（ADA）、癌胚抗原（CEA）、糖类抗原153（CA53）、神经元烯醇化酶（NSE）、糖类抗原199（CA199）对渗出性胸腔积液鉴别诊断的价值。方法应用电化学发光法测定胸腔积液患者的血清及胸水CEA、CA153、NSE、CA199水平，采用酶偶联速率法测定胸水ADA水平，并评价联合检查对胸腔积液的诊断价值。结果结核性胸腔积液组胸水ADA含量为（65．89±19．81）U／L，恶性组为（27．44±22．64）U／L，炎性组为（17．33±16．58）U／L，结核组显著高于其余2组（q=12．19、10．72，P均〈0．01）。结性胸腔积液组ADA阳性29例（82．88％），恶性组11例（13．41％），炎性组2例（11．11％），组间比较差异有统计学意义（χ2=59．07，P〈0．01）。恶性胸腔积液组CEA、CA153、NSE、CA199含量和阳性率均高于结核纽，差异均有统计学意义（P均〈0．05），炎性组和恶性组相比差异无统计学意义。82例恶性胸腔积液患者血清4项肿瘤标记物联检阳性率为74．3％（61／82），胸腔积液中阳性率为82．9％（68／82）。结论ADA、CEA、CA153、NSE、CA199联合检测对胸腔积液的鉴别诊断具有一定意义。
Objective To evaluate the differential diagnostic values of combined detection of adenosine deaminase （ ADA ）, carcinoembryonic antigen （ CEA ）, carbohydrate antigen 153 （ CA153 ） , neuron-specijie enolase （NSE） and carbohydrate antigen 199 （CA199） in patients with pleural effusion. Methods Serum and hydrothorax fluid of CEA, CA153,NSE and CA199 in patients with pleural effusion were measured by electroehemiluminescence assay（ECLA） , ADA from pleural effusions were measured by enzyme rate assay, and the clinical value of combined detection in the differential diagnosis of pleura] effusion was evaluated. Results The levels of ADA（ 65.89 ± 19.81 U/L） in hydrothorax fluid group with tuberculous pleural effusion were both higher than those in the groups with in- flammatory pleural effusion （ 17.33 ± 16.58 ）U/L and malignant pleural effusion （27.44 ±22.64）U/L （q = 12.19 and 10.72 ,P 〈 0.01 ）. The positive rate of ADA was 82.88% （29/135）in hydrothorax fluid group with tuberculous pleural effusion, 13.41% （11/135 ）in malignant pleural effusion and 11.11% （2/135）in inflammatory pleural effusion（χ2 = 59.07 ,P 〈 0.01 ）. The levels and positive rate of CEA, CA153, NSE, and CA199 in serum and hydrothorax fluid group with malignant pleural effusion were both higher than those in the group with tuberculous pleura[ effusion （P 〈 0.05）. Compared with the group with malignant pleural effusion, the levels of CA153 and CA199 in serum and the levels and the positive rate of NSE in serum and hydrothorax fluid were not statistically different in inflammatory pleural effusion group. In the 82 cases with malignant pleural effusion, the positive rate of the four kinds of serum tumor markers including CEA, CA153, NSE and CA199 was 74.39% （61/82） and the positive rate of those hydrothorax fluid tumor markers was 82.93% （68/82）. Conclusions Combined detection of ADA, CEA, CA153, NSE and CA199 is of some significance to the differential diagnosis of pleural effusion.
出处
《中国综合临床》
2009年第12期1281-1283,共3页
Clinical Medicine of China
关键词
胸腔积液
腺苷脱氨酶
癌胚抗原
糖类抗原153
神经元烯醇化酶
糖类抗原199
Pleural effusion
Adenosine deaminase
Carcino embryonic antigen
Carbohydrate antigen 153
Neurone-specific enolase
Carbohydrate antigen 199
