ADA、CEA和CA19-9联合检测对老年结核和肿瘤性胸水的鉴别诊断价值  

THE VALUE OF ADA, CEA AND CA19 9 IN THE DIFFERENTIAL DIAGNOSIS OF MALIGNANT AND TUBERCULOUS PLEURAL EFFUSION

作　　者：董淑文[1] 蔡凤云[1] 燕相山 徐敏 

机构地区：[1]首都医科大学附属北京天坛医院呼吸内科

出　　处：《中国癌症杂志》1997年第2期112-114,共3页China Oncology

摘　　要：探讨腺苷脱氨酶（ＡＤＡ）、癌胚抗原（ＣＥＡ）和癌抗原１９－９（ＣＡ１９－９）对老年结核和肿瘤性胸水的鉴别诊断价值。方法检测经病理确诊的≥６０岁的３２例结核性胸膜炎和２０例癌性胸水中的ＡＤＡ、ＣＥＡ和ＣＡ１９－９含量。结果单项检测：ＡＤＡ诊断结核性胸膜炎的敏感性为５７．３％，特异性为９５％，准确度为９５％；ＣＥＡ和ＣＡ１９－９诊断肿瘤性胸水的敏感性分别为６５％和７０％，特异性为８８％和９４％，准确度为７５％和８８％。联合检测：以三项同时符合结核或癌性胸水为诊断依据时，结核和癌性胸水的敏感性分别为５０％和６５％，特异性和准确度均为１００％。结论ＡＤＡ、ＣＥＡ和ＣＡ１９－９联合检测对老年结核与癌性胸水有较高的鉴别诊断价值。PURPOSE Investigation of the value of ADA, CEA and CA19 9 in the differential diagnosis of malignant and tuberculous pleural effusion. METHODS The activity of ADA, CEA and CA19 9 was tested in 32 elderly patients with tuberculous pleural effusion and in 20 other elderly patients with malignant pleural effusion, which was verified by pathology. RESULTS The sensitivity, specificity and diagnostic accuracy rate of ADA for the tuberculous pleural effusion were 57.3%,95% and 94% respectively.The CEA rates for malignant pleural effusion were 65%, 88%, 76% and 70% respectively, while the CA19 9 rates were 70%, 94% and 87% respectively. When the three tests were used in combination, the sensitivity rate was 50% for TB and 65% for malignant pleural effusion; the specificity and diagnostic accuracy rates of the two groups were 100%. CONCLUSIONS ADA, CEA and CA19 9 are valuable in differentiating between malignant and tuberculous pleural effusion.

关 键 词：癌胚抗原 癌性胸水 结核性胸膜炎 肿瘤 诊断 

分 类 号：R521.7[医药卫生—内科学] R730.4[医药卫生—临床医学]