CA125、ADA、CEA、CRP联合检测对胸腔积液的鉴别诊断价值  

Combined Detection of CA125、CRP、CEA、ADA in Differential Diagnosis of Malignant Pleural Effusion

作　　者：刘妍丽 韩丹 陆兰英 

机构地区：[1]武汉市结核病防治所,430030

出　　处：《实用癌症杂志》2014年第3期272-275,共4页The Practical Journal of Cancer

摘　　要：目的探讨胸腔积液中的糖链抗原125(CA125)、腺苷脱氨酶(ADA)、癌胚抗原(CEA)和C反应蛋白(CRP)对鉴别良恶性胸腔积液的诊断价值。方法 60例结核性胸腔积液患者作为良性组,60例恶性胸腔积液患者为恶性组。用免疫比浊法、酶比色法和电化学荧光法检测2组患者胸腔积液中CA125、ADA、CEA、CRP的浓度。结果良性组的ADA和CRP浓度均显著高于恶性组(P<0.001),而其CEA与CA125则显著低于恶性组(P<0.001)。在良性组中,ADA和CRP的诊断敏感性高于CEA和CA125,且具有统计学意义,但在诊断特异性方面4个指标间的差异均无统计学意义。在恶性组中,ADA、CRP的诊断敏感性高于CEA和CA125,CEA、CA125、ADA的诊断特异性均高于CRP,具有统计学意义。对良性胸腔积液的诊断,CRP联合ADA的敏感性为85.0%,特异性为89.0%;CRP、ADA、CEA联合CA125的敏感性和特异性提高到97.4%,92.9%。对恶性胸腔积液的诊断,CEA联合CA125的敏感性为71.2%、86.7%,CA125、CEA、CRP、ADA联合检测的敏感性提高到94.0%、95.5%。结论 CA125、ADA、CEA、CRP联合检测可以提高对良恶性胸腔积液诊断的敏感性和特异性。Objective To assess the clinical value of carbohydrate antigen 125 (CA125),adenosinedeaminase(ADA), carcino-embryonicantigen(CEA)and C-reactive protein(CRP) in differential diagnosis of pleural effusion .Methods 60 patients with tuberculous pleural effusion were selected as the benign group and 60 patients with malignant pleural effusion were selected as the malignant group .Concentration of CA 125、ADA 、CEA and CRP in pleural effusion of the 2 groups were detected by im-mune turbidimetry ,enzyme colorimetry and electrochemical fluorescence .Results Concentration of ADA and CRP in the benign group were significantly higher than those of the malignant group (P<0.001),and concentration of CEA and CA 125 in the be-nign group was significantly lower than that of the malignant group (P<0.001).In the benign group,the diagnostic sensitivity of ADA and CRP was higher than that of CEA and CA 125,there had statistical difference .There had no statistical difference in the diagnostic specificity of the four index .In the malignant group ,the diagnostic sensitivity of ADA and CRP was higher than that of CEA and CA125.And the diagnostic specificity of CEA ,CA125,ADA was significantly higher than that of CRP ,there had statisti-cal difference .In the benign group ,the diagnostic sensitivity of CRP and ADA was 85%,and the diagnostic specificity of CRP and ADA was 89%;the diagnostic sensitivity and specificity of CRP ,ADA,CEA and CA125 were 97.4%and 92.9%.QIn the ma-lignant group,the diagnostic sensitivity and specificity of CEA and CA 125 were 71.2%and 86.7%;the diagnostic sensitivity and specificity of CA125,CEA,CRP,ADA were 94.0% and 95.5%.Conclusion Joint detection of CA125,ADA,CEA and CRP can improve the sensitivity and specificity in differentiating diagnosis of benign and malignant pleural effusion .

关 键 词：胸腔积液 鉴别诊断 糖链抗原125 C反应蛋白 癌胚抗原 腺苷脱氨酶 

分 类 号：R734.2[医药卫生—肿瘤]