端粒酶和CYFRA 21-1对良恶性胸腔积液的鉴别价值  

THE VALUE OF TELOMERASE ACTIVITY AND LEVEL OF CYFRA 21-1 IN DIFFERENTIAL DIAGNOSIS BETWEEN BENIGN AND MALIGNANT PLEURAL EFFUSION

作　　者：李红梅[1] 于壮[1] 顾华丽[2] 胡晓晓[2] 

机构地区：[1]青岛大学医学院附属医院肿瘤中心,山东青岛2660031 [2]青岛大学医学院附属医院急症科,山东青岛2660031

出　　处：《青岛大学医学院学报》2010年第4期304-306,共3页Acta Academiae Medicinae Qingdao Universitatis

基　　金：山东省医药卫生科研项目(2007BW09)

摘　　要：目的研究端粒酶和细胞角蛋白19片段(CYFRA 21-1)测定对鉴别良、恶性胸腔积液的价值。方法采用端粒重复序列扩增-酶联免疫吸附实验法(TRAP-PCR-ELISA)和酶免疫分析法(EIA),分别测定80例恶性胸腔积液和50例良性胸腔积液中的端粒酶活性和CYFRA 21-1水平。结果胸腔积液中端粒酶活性和CYFRA 21-1的阳性率在恶性胸腔积液组分别为77.5%(62/80)和60.0%(48/80),在良性胸腔积液组分别为6.0%(3/50)和22.0%(11/50),两组比较差异有显著性(χ2=62.921、17.925,P均<0.001)。端粒酶活性测定诊断恶性胸腔积液的灵敏度为77.5%(62/80),特异度为94.0%(47/50);CYFRA 21-1诊断的灵敏度60.0%(48/80),特异度78.0%(39/50),两组比较差异有显著性(χ2=4.103、5.316,P<0.05)。两者联合检测的灵敏度为90.0%(72/80),特异度为82.0%(41/50),联合检测的灵敏度高于端粒酶和CYFRA 21-1单项检测(χ2=4.592、19.201,P<0.05、0.001)。结论端粒酶和CYFRA 21-1测定对鉴别良恶性胸腔积液均有一定的价值,其中端粒酶测定的灵敏度和特异度较CYFRA 21-1高,两者联合测定可提高诊断准确率。Objective To study the value of telomerase activity（TA） and the level of CYFRA 21-1 in differential diagnosis between benign and malignant pleural effusion. Methods TA and level of CYFRA 21-1 were respectively examined by means of telomeric repeat amplification protocol-PCR-ELISA（TRAP-PCR-ELISA） and EIA from 80 specimens of malignant pleural effusion and 50 benign pleural effusion. Results The positive rates of TA and CYFRA 21-1 were 77.5%（62/80） and 60.0%（48/80）,respectively,in specimens of malignant pleural effusion;and 6.0%（3/50） and 22.0%（11/50） in benign one,the differences between them were significant（χ2=62.921,17.925;P0.001）.Sensitivity of TA in the diagnosis of malignant effusion was77.5%（62/80）,specificity was 94%（47/50）,while that of CYFRA 21-1 level was 60.0%（48/80） and 78%（39/50）,the differences between them were also significant（χ2=4.103,5.316;P0.05）.However,the sensitivity of the combined testing was90.0%（72/80） and the specificity was 82.0%（41/50）,which were higher than either of telomerase or CYFRA 21-1 testing alone（χ2=4.592,19.201;P0.05,0.001）. Conclusion Detection of the TA and CYFRA 21-1 in pleural effusion is of a definite value in differentiating benign from malignant pleural effusion,and the detection of TA is more sensitive and specific than detection of CYFRA 21-1.Combined detection of both markers may raise the accuracy of the diagnosis.

关 键 词：端粒酶 CYFRA21-1 胸腔积液 诊断 鉴别 

分 类 号：R730.4[医药卫生—肿瘤]