胸水和血清ADA、CEA联合检测对良恶性胸腔积液的诊断价值  

Differential diagnostic value of pleural effusion combined with serum ADA and CEA between and malignant pleural exudates

作　　者：沈丽[1] 王宇[1] 

机构地区：[1]重庆市肺科医院,400020

出　　处：《临床肺科杂志》2007年第7期662-663,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨胸水/血清腺苷脱氨酶(ADA)、癌胚抗原(CEA)联合检测对良恶性胸腔积液的鉴别诊断价值。方法采用酶连续监测法和酶联免疫(ELISA)双抗体夹心法对119例胸腔积液进行胸水/血清ADA和CEA检测分析。结果CEA在结核性和癌性胸腔积液中的阳性率分别为8.20%和63.6%,特异性91.8%(89/97)。ADA活性在结核性和癌性胸腔积液中分别为(59.62±29.86)U/L和(15.31±7.36)U/L(P<0.01)。以P-ADA>40U/L做为诊断结核的临界值,其敏感性为79.3%,特异性为86.4%;以P-ADA/S-ADA>1为临界值,其敏感性为97.7%,特异性为95.5%。结论胸腔积液ADA、CEA检测对良恶性胸腔积液具有诊断与鉴别诊断价值。Objective To study the diagnostic value of pleural effusion combined with serum adenosine deaminase （ ADA）, carcinoe mbryonic antigen （CEA） in testing malignant pleural exudates. Methods Diagnostic kit for carcinoe mbryonic antigen （CEA） measured by ELISA and ADA was examined using continuous monitored enzymatic method among 119 cases of pleural exudates patients. Results The positive rates of TB-Ab-IgG in pleural effusion and in serum of 87 cases were 62. 0% and 70. 1% respectively. The ADA activity of tuberculous and malignant exudates were, respectively, （59. 58 ± 29. 85 ） U/L and （ 15.31 ± 7. 36 ） U/L（ P 〈 0. 01 ）. If the cut-off point of ADA was larger than 40 U/L in tuberculous diagnosis, its sensitivity was 79. 3% and its specificity was 86. 4%. If the cut- off value of P-ADA/S-ADA was larger than 1 in tuberculous diagnosis, its sensitivity was 97.7% and the specificity was 95.5%. Conclusion The test of ADA and CEA of pleural exudates is of great value in differentiating benign from malignant exudates.

关 键 词：腺苷脱氨酶(ADA) 癌胚抗原(CEA) 胸腔积液 检测 

分 类 号：R446.6[医药卫生—诊断学]