摘要
目的:探讨癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白片段19(CYFRA21-1)和神经元特异性烯醇化酶(NSE)联合检测在良恶性胸腔积液鉴别诊断中的价值。方法:电化学发光法检测56例恶性胸腔积液患者和78例良性胸腔积液患者的CEA、CA125、CYFRA21-1和NSE的浓度和阳性表达率,比较其差异。结果:恶性组与良性组CEA(t=5.102)、CA125(t=4.294)、CYFRA21-1(t=3.602)和NSE(t=2.142)浓度进行比较,差异均有统计学意义,P值均<0.05。恶性组与良性组CEA(χ2=69.07)、CA125(χ2=67.34)、CYFRA21-1(χ2=73.99)和NSE(χ2=78.59)阳性率进行比较,差异有统计学意义,P值均<0.01。单项检测各种肿瘤分子标志诊断良恶性胸腔积液的敏感度和特异性以CEA最高,分别为33.93%(19/56)和97.44%(76/78)。联合检测较单项检测敏感度明显增高。2项检测以CEA和CYFRA21-1敏感性和特异性最高,分别为44.64%(25/56)和96.15%(75/78)。3项检测以CEA、CYFRA21-1和NSE联合检测敏感性和特异性最高,分别为51.79%(29/56)和91.03%(71/78)。CEA+CA125+CYFRA21-1+NSE 4项联合检测效果最佳,其敏感性高达53.57%(30/56),特异度达85.90%(67/78)。结论:胸腔积液CEA、CA125、CYFRA21-1和NSE联合检测在良恶性胸腔积液鉴别诊断中有重要意义。
OBJECTIVE：To analysis the value of differential diagnosis of combined measurement of CEA,CA125, CYFRA21-1,NSE in pleural effusions. METHODS： CEA, CA125,CYFRA21-1 and NSE in pleural effusions were meas- ured by electrochemiluminescent immunoassay in one group of 56 patients with malignant pleural effusion and another group of 78 patients with benign lung diseases. The concentration and the positive rate between two groups of patients were compared. RESULTS：Between two groups the concentration of CEA（t= 5. 102）, CA125 （t= 4. 294）, CYFRA21-1 （t=3. 602） and NSE （t=2. 142） were significantly different （P〈O. 05）. Between the two groups the difference of posi- tive rates of CEA （X2 =69.07）,CA125（X2 =67.34）,CYFRA21-1（X2 =73.99） and NSE （X2 =78.59） were statistically significant （P〈0.01）. CEA had the highest sensitivity and specificity when a single tumor marker was used in differential diagnosis from pleural effusions 1-33.93% （19/56） and 97.44% （76/78）] ,and the combined measurement of several tumor molecular markers had higher sensitivity than that of the single marker. When 2 markers was used, the combination of CEA and CYFRA21-1 had the highest sensitivity and specificity [44. 64% （25/56） and 96.15% （75/78）]. And when 3 markers was used, the combination of CEA, CYFRA21-1, NSE had the highest sensitivity and specificity [51. 79% （29/56） and 91.03%（71/78）]. The combination of CEA＋CA125-4-CYFRA21-1＋NSE had the most significant effect, its sensitivity was as high as 53.57% （30/56） ,and its specificity was 85.90% （67/78）. CONCLUSlON：CEA,CA125 ,CY- FRA21-1 ,NSE detections from benign and malignant pleural effusion have important meanings in differential diagnosis.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第10期772-774,共3页
Chinese Journal of Cancer Prevention and Treatment
