6种肿瘤标志物检测恶性胸腹水的临床价值  

Clinical Value of Detection of Malignant Ascites and Thoracic Exudate by Means of Six Tumor-Markers

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

机构地区：[1]南通市肿瘤医院核医学科,江苏南通226361

出　　处：《肿瘤基础与临床》2008年第3期242-244,共3页journal of basic and clinical oncology

摘　　要：目的探讨CA125等6种肿瘤标志物检测170例恶性胸腹水的临床价值,并与细胞学检查进行对照。方法采用ECL法。结果所有6项肿瘤标志物检测,无论阳性率或与细胞学检查符合率均以CA125为最高,其顺序为CA125>CA-50>CA15-3>CY-FRA21-1>β-HCG>HCG。CA15-3、HCG及β-HCG虽然阳性率没有CA125高,但由于没有假阳性,或假阳性率低,仍具有较高的临床价值。CYFRA21-1检测恶性腹水具有较高的特异性。结论联合检测恶性胸水建议首选CA125+CYFRA21-1,次为CA125+CA-50、CYFRA21-1+CA-50、CYFRA21-1+CA15-3;恶性腹水应首选CA125+β-HCG,次为CA125+CYFRA21-1。当临床明确癌肿原发灶或高度怀疑为恶性胸腹水,肿瘤标志物检测获下列结果之一者:CA125、CYFRA21-1、CA-50、CA15-3四项中有两项阳性;前述四项有一项阳性+β-HCG或HCG阳性;CA15-3与HCG或β-HCG均阳性,结合脱落细胞检查,可辅助临床作出恶性胸腹水的诊断。Objective To study the clinical value of six potential tumor markers including serums CA125, CYFRA21-1, CA-50, CA15-3, HCG, β-HCG. These were determined in effnsions of malignant ascites and hydrothorax of 170 patients, with cellular examination as control. Methods Using ECL. Results The data of our experiments revealed that of all six tumor-markers, CA125 was the highest in positive rate as well as concordance rate with cytology examination. In order CA125, CA-50, CA15-3, CYFRA21-1, β-HCG. It was valuable to point out that the specificity of HCG and β-HCG was very strong and there was no false positivity had yet been found with them. Though their positivity was not so high as that of CA125. Have to higher specificity of detection of malignant ascites by CYFRA21-1. Conclusions It suggested that ＋ CYFRA21-1 should be the preferred choice in diagnosing malignant hydrothorax next ＋ CA-50, CYFRA21-1 ＋ CA-50 ; for malignant ascites as well, CA125 ＋ β-HCG determination is just as good, next CA125 ＋ CYFRA21-1. We believe that when a clear diagnosis of a primary focus of cancer is made clinically,or a malignant ascites or thoracic exudate come highly under suspicion, the diagnosis of malignancy of the ascites or thoracic exudates can be established even though the exfoliative cells, provided the detection by tumor-markers, it has got one of the following results： the roles of tumor-markers determination in malignant serous effusions,two of CA125, CYFRA21-1 ,CA15-3 and CA-50 markers are positive;anyone of the above markers plus HCG or β-HCG positivity;both HCG and β-HCG or CA15-3 are positive.

关 键 词：胸腹水 肿瘤标志物 电化学发光(ECL) 恶性腹水 

分 类 号：R730.43[医药卫生—肿瘤]