应用CEA及CA19-9鉴别良、恶性胸腔积液临床意义的探讨  

Clinical Significance of Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 in the Differential Diagnosis of Benign and Malignant Pleural Effusion

作　　者：顾金萍[1] 王秋月[1] 闫雪[1] 胡雪君[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院呼吸疾病研究所,沈阳110001

出　　处：《中国医科大学学报》2008年第5期667-669,共3页Journal of China Medical University

基　　金：辽宁省教育厅高等学校科研基金资助项目(20060992)

摘　　要：目的探讨胸水中癌胚抗原(CEA)及糖链抗原19-9(CA19-9)测定在鉴别良性与恶性胸腔积液的临床意义。方法用酶联免疫吸附测定(ELISA)法同步测定172例恶性胸腔积液与149例良性胸腔积液的CEA及CA19-9含量,并分析其诊断的敏感性和特异性及其在临床应用的价值。结果分别以胸腔积液中CEA≥5ng/ml,≥15ng/ml,≥20ng/ml,≥30ng/ml,≥40ng/ml和≥60ng/ml为阳性判定标准,其诊断恶性胸腔积液的灵敏度分别为59.88%、47.67%、46.51%、40.70%、38.37%和32.56%,特异度分别为86.58%、93.96%、94.63%、96.64%、98.66%和98.66%。以胸腔积液中CA19-9≥37U/ml为阳性判定标准,诊断恶性胸腔积液的灵敏度和特异度分别为28.22%和95.95%。结论CEA和CA19-9在恶性与良性胸腔积液鉴别诊断中具有较重要的临床意义,胸腔积液中CEA≥40ng/ml或CA19-9≥37U/ml提示恶性胸腔积液的可能性分别是97.06%和88.46%。Objective To study the clinical significance of determining carcinoembryonic antigen （CEA） and carbohydrate antigen 19-9 （CA19-9） in the differential diagnosis of benign and malignant pleural effusion. Methods Pleural effusion CEA and CA19-9 were determined in 172 patients with malignant pleural effusion and 149 patients with benign pleural effusion by ELISA method and their diagnostic sensitivity and specificity were analyzed. Results With CEA≥5 ng/ml, ≥15 ng/ml ,≥20 ng/ml, ≥30 ng/ml and ≥40 ng/ml in pleural effusion as positive judgment standard, their sensitivities were 59.88%, 47.67%, 46.51%, 40.70%, 38.37% and specificities were 86.58%, 93.96% ,94.63% ,96.64% ,98.66% respectively. With CA19-9 ≥37U/ml in pleural effusion as positive judgment standard,their sensitivity and specificity were 28.22% and 95.95%. Conclusion Determination of CEA and CA19-9 in pleural effusion plays an important role in the differential diagnosis of benign and malignant pleural effusion. When the level of CEA is ≥40 ng/ml or the level of CA19-9 in pleural effusion is ≥ 37U/m, the possibilities of malignant pleural effusion are 97.06% and 88.46% respectively.

关 键 词：癌胚抗原 糖链抗原19-9 胸腔积液 

分 类 号：R561.3[医药卫生—呼吸系统]