HCG、β-HCG RIA鉴别良、恶性胸、腹腔积液的临床价值  

The Clinical Diagnostic Value of Determination of Contents of HCG and β-HCG in Ascitic and Pleural Effusion Fluid for Differentiating Malignant From Benign Diseases

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,226361

出　　处：《放射免疫学杂志》2007年第4期315-317,共3页Journal of Radioimmanology

摘　　要：目的:本文探讨HCG、β-HCG RIA鉴别良、恶性胸腹腔积液的临床价值。方法:采用RIA。结果:①良性胸腹腔积液组无1例假阳性。提示HCG、β-HCG RIA检测恶性胸腔积液的特异性高。②HCG、β-HCG单项检测阳性率:恶性胸腔积液组HCG55.64%(44/79),β-HCG62.02%(49/79);恶性腹腔积液组HCG43.58%(34/76),β-HCG66.66%(52/78);恶性心包积液组HCG、β-HCG均高达92.30%(12/13)。③HCG、β-HCG阳性与脱落细胞阳性符合率,HCG达65.93%(60/91)、β-HCG达73.62%(67/91);HCG+β-HCG双阳性符合率达47.25%(43/91)。④79例脱落细胞阴性病例中,HCG、β-HCG阳性者分别占50例及60例,阳性率分别达63.29%及75.94%,其中尤以脱落细胞阴性的6例恶性心包积液者,HCG、β-HCG检测均呈阳性。⑤122例腺、鳞癌病例分组分析表明,无论是HCG、还是β-HCG检测总阳性者在两组间并无统计学意义。但恶性胸腔积液组腺、鳞癌患者HCG检测结果表明,腺、鳞癌两组间有显著性差异t=2.17,P<0.05,提示恶性胸腔积液鳞癌患者以选用HCG为佳。结论:作者认为,鉴别良、恶性胸腹腔积液(含心包积液)的性质,在排除妊娠情况下,若单项HCG或β-HCG阳性应高度怀疑恶性的可能,若HCG、β-HCG双阳性时,则可作出恶性的诊断,为临床提供治疗依据。Objective To investigate the chinical value of effusion fluid HCG and β- HCG content determination in the differentiation of malignant from benign disorders. Methods Fluid contents of HCG and β - HCG were determined with RIA in （1） 50 cases with benign pleural effusion. （2） 50 cases with benign recites. （3） 79 cases with malignant pleural effusion. （4） 78 cases with malignant asites and （5） 13 cases with malignant pericardial effusion. Results （1） No false positive cases were present among the 100 benign eases, suggesting a high specificity with HCG and β- HCG determination. （2） Positive rate of HCG in malignancy ： malignant pleural ettusiort, 55.64% （44/79）, malignant ascites, 43.58% （34/76）, malignant pericardial effusion 92.30% （12/13）. （3） Positive rate of β- HCG in malignancy： malignant pleural effusion, 62.02% （49/79）, malignant ascites, 66.66% （52/78）, malignant peri- eardial effusion, 92.30% （12/13）. （4） Coincidence of 91 cases of positive exfoliative cytology and tumor markers： HCG, 65.93% （60/91）, β - HCG 73.62% （ 67/91 ）, combined HCG and β- HCG, 47.25% （ 43/91 ）. （5） In 79 cases with negative cytology, HCG was positive in 50 cases （63.29%） and β- HCG was positive in 60 cases （75.94%）. A remarkable event was： both HCG and β- HCG were positive in 6 cases of malignant pericardial effusion with negative cytology. （6） In malignant pleural effusions, positive rate of HCG was much higher in the 14 cases with squamous cell carcinoma （78.57% , 11/14） than that in the 33 cases with adeno- earelnoma （48.48%）, 16/33） （P 〈0.05）, therefore, HCG was the marker of choice in cases with effusion from SCluamous cell earclnoma. Conclusion In the abscence of pregnancy, malignancy is highly probable with positive HCG or β- HCG in aseitic or pleura/ effusion fluid and the diagnosis is almost certain with combined positiveness.

关 键 词：胸腹腔积液 肿瘤标志物 放射免疫分析(RIA) 

分 类 号：R714.221[医药卫生—妇产科学]