CYFRA 21-1、CEA、CA19-9,CA15-3和CA125在胸水中的诊断价值:116例分析及文献复习  

Diagnostic Value of CYFRA 21-1,CEA,CA 19-9,CA 15-3,and CA 125 Assays in Pleural Effusions: Analysis of 116 Cases and Review of the Literature

作　　者：侯著法[1] 

机构地区：[1]湖北民族学院医学院附属医院血液科,湖北恩施445000

出　　处：《湖北民族学院学报（医学版）》2007年第1期37-40,43,共5页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的评估CYFRA21-1、CEA、CA19-9,CA15-3和CA125在胸水中的诊断价值。方法收集116例患者胸水,测定CYFRA21-1、CEA、CA19-9,CA15-3和CA125在其胸水中的含量;在美国MEDLINE系统中检索近15年相关文献。结果所有肿瘤标记物在恶性胸水中的含量均高于良性胸水。CEA的准确度最高,达85.3%;CA15-3、CYFRA21-1和CA19-9的准确度相似,分别为71.5%,72.4%,71.5%;CA125准确度最低,仅40.5%。联合检测其准确度不高于单一指标CEA。Logistic回归分析显示对恶性胸水的预测最有统计学意义的指标是CA15-和CYFRA21-1。文献复习显示CEA,CA15-3和CYFRA 21-1诊断价值最佳。结论胸水CEA检测具有最高的准确度,其他肿瘤标记物,特别是CA15-3和CYFRA21-1可作为备选标记物。Objective The aim of this study was to assess the diagnostic value of five common pleural fluid tumor markers, carcinoembryonic antigen （CEA）, cytokeratin fragment （CYFRA） 21 - 1, cancer antigen （CA） 15 - 3, CA 19 - 9, and CA 125, and to review the literature from the past 15 years. Methods Pleural fluid samples were collected prospectively from 116 patients and assayed for CEA, CYFRA 21 -1, CA 15 -3, CA 19 -9, and CA 125 levels. Results The levels of all pleural tumor markers were statistically significantly higher in the malignant group than in the benign group. The marker with the highest accuracy was CEA （85.3%） ; CA 15 -3, CY- FRA 21 -1, and CA 19-9 had similar accuracies （75.2%, 72.4% , and 71.5%, respectively）, and CA 125 had the lowest accuracy （40.5%）. Tumor - marker combinations did not result in a greater accuracy than that of CEA alone. On multivariate logistic regression, CA 15 -3 and CY- FRA 21 -1 were significant predictors of malignancy. Among the nine reports in the literature comparing 11 different tumor markers, CEA, CA 15 - 3, and CYFRA 21 - 1 yielded the best results. Conclusion We conclude that pleural fluid analysis should include CEA for the diagnosis of malignancy. CA 15 -3 and CYFRA 21 - 1 may serve as alternative options.

关 键 词：胸水 诊断 肿瘤标记物 文献复习 

分 类 号：R446.1[医药卫生—诊断学]