端粒酶与CYFRA21-1联合测定对肺癌所致恶性胸腔积液同良性胸腔积液鉴别的诊断意义  

Diagnostic Significance of Combining Telomerase Activity with CYFRA21-1 Level in Differentiating Malignant Pleural Effusion Caused by Lung Cancer from Benign Pleural Effusion

作　　者：李红梅[1,2] 付军桦[2] 修元德[2] 周清华[1] 

机构地区：[1]天津医科大学总医院肺癌研究所,天津300052 [2]青岛大学医学院附属医院肿瘤中心,青岛266003

出　　处：《中国肺癌杂志》2010年第6期652-654,共3页Chinese Journal of Lung Cancer

基　　金：山东省医药卫生科研项目(2007BW09)资助~~

摘　　要：背景与目的恶性胸腔积液中端粒酶和CYFRA21-1均可呈阳性表达,单个肿瘤标志物测定存在敏感性和特异性均较低的问题。本文旨在探讨端粒酶和CYFRA21-1联合测定对肺癌所致恶性胸腔积液同良性胸腔积液的鉴别诊断意义。方法80例肺癌致恶性胸腔积液和50例良性胸腔积液患者,采用端粒重复序列扩增-酶联免疫吸附法检测胸腔积液端粒酶活性,用酶免疫分析法检测CYFRA21-1水平,对测定结果进行统计学处理。结果恶性胸腔积液端粒酶和CYFRA21-1水平明显高于良性胸腔积液,差异有统计学意义(t=17.252和t=13.951,P<0.001)。端粒酶活性诊断的敏感性为71.3%,特异性为86.0%,准确性为76.9%。CYFRA21-1诊断的敏感性为60.0%,特异性为78.0%,准确性为66.9%。两者联合测定的敏感性为90.0%,特异性为76.0%,准确性为86.9%。联合测定的敏感性和准确性均高于单项测定(χ2=9.002和χ2=19.201,P<0.01;χ2=4.389和χ2=14.647,P<0.05)。结论端粒酶和CYFRA21-1联合测定可提高良恶性胸腔积液鉴别诊断的敏感性和准确性。Background and objective Telomerase and CYFRA21-1 may be positively expressed in malignant pleural effusion, but the sensitivity and specificity of single tumor marker were low. The aim of this study is to investigate the diagnostic value of combining determination of telomerase activity and CYFRA21-1 levels in differentiating benign from malignant pleural effusion caused by lung cancer. Methods 80 patients with malignant and 50 patients with benign pleural effusion were enrolled into this study. The telomerase activity in pleural effusion was tested by means of telomeric repeat amplification protocal-PCR-ELISA （TRAP-PCR-ELISA） and CYFRA21-1 levels were tested by the EIA method. All the results were analyzed by the statistical method. Results The levels of telomerase and CYFRA21-1 in malignant pleural effusion was significantly higher than that in benign one （t =17.252 and t =13.951, P0.001）. The sensitivity of telomerase activity testing for diagnosing malignant pleural effusion was 71.3%; the specificity was 86.0% and the overall accuracy was 76.9%. The sensitivity of CYFRA 21-1 testing was 60.0%, the specificity was 78.0% and the overall accuracy was 66.9%. The sensitivity of the combined testing was 90.0%, the specificity was 76.0% and the overall accuracy was 86.9%. The sensitivity and the overall accuracy of combined testing were higher than those of telomerase and CYFRA21-1 testing single（χ2=9.002 and χ2=19.201, P0.01; χ2=4.389 and χ2=14.647, P0.05）. Conclusion The combined testing of telomerase with CYFRA21-1 can increase the sensitivity and overall accuracy of differential diagnosis of benign and malignant pleural effusion diagnosis.

关 键 词：端粒酶 CYFRA21-1 胸腔积液 鉴别诊断 

分 类 号：R734.2[医药卫生—肿瘤]