CYFRA21-1、CA153单项及联检诊断肺癌癌性胸水的临床价值  

Clinical Usefulness of Single and Combined Pleural Effusion Fluid Tumor Markers Assay(CYFRA21-1 and CA153) in the Detection of Pumonary Carcinoma

作　　者：李建刚[1] 吉志固[1] 朱自力[1] 徐平[1] 刘云[1] 陆小鹏[1] 张福明[1] 

机构地区：[1]江苏省南通市肿瘤医院核医学科南通大学附属肿瘤医院,226361

出　　处：《放射免疫学杂志》2006年第4期274-276,共3页Journal of Radioimmanology

摘　　要：目的:本文探讨肿瘤标志物CYFRA21-1、CA153单项及两项联检诊断肺癌癌性胸水的临床价值。方法:采用R IA法。结果:本文对51例肺癌癌性胸水及38例结核性胸膜炎良性胸水同时检测CYFRA21-1及CA153,结果表明良性组CYFRA21-1有2例假阳性(5.26%);CA153无假阳性病例。恶性组CYFRA21-1,31例阳性,阳性率60.78%,CA153,29例阳性,阳性率56.86%,良恶性组经统计学处理有显著性差异(P<0.01)。CYFRA21-1、CA153病例与脱落细胞符合率均在50%以上,CYFRA21-1+CA153联检可使单项阳性率提高到92.1%。结论:两项肿瘤标志物均对良恶性胸水的鉴别诊断具有可信的临床价值。由于CA153无假阳性、特异性高于CYFRA21-1,故作为单项使用,建议首选CA153,为减少漏诊,仍应采用CYFRA21-1+CA153联检为宜。在临床高度怀疑恶性胸水,而脱落细胞检查阴性情况下,采用此方案更有辅助诊断价值。Objective To explore the clinical usefulness of effusion fluid CYFRA21 - 1 and CA153 determination in the differential diagnosis of malignancy. Methods Pleural effusion fluid contents of CYFRA21 - 1 and CA153 were measured with RIA in 51 patients with pulmonary carcinoma and 38 patients with tuberculosis. Results There were two CYFRA21 - 1 false positive cases （5.26%） in the 38 patients with tuberculosis effusion, but no CA153 false positive cases were present. In the 51 patients with malignant effusion, CY- RA21 - 1 was positive in 31 cases （60.78%） and CA153 was positive in 29 cases （56.86%） （ vs those in benign effusion, P 〈 0. 001 ）. Malignant cells were demonstrated in the effusion fluid in 25 of the 51 patients （49.01%）. Of the 25 patients, CYFRA21 - 1 was posstive in 17（68.0% ） and CA153 was positive in 13 （52.2%）. Combined determination of CYFRA21 -1 with CA153 would yield a positive rate of 92.15%. Conclusion As CA153 possesses higher specificity （no false positiveness）, it should be the diagnostic marker of first choice. However, combined CA153 and CYFRA21 - 1 test should be employed due to its very high sensitivity （92.15%）. Combined determination is especially useful in those cases with negative cytological findings in the effusion fluid.

关 键 词：胸水 肿瘤标志 放射免疫分析 

分 类 号：R734.2[医药卫生—肿瘤]