良恶性胸腔积液鉴别中SP70检测的临床意义  

The significance of protein SP70 detection for differentiating benign and malignant pleural effusion

作　　者：杨瑞霞 潘世扬 王芳[1] 徐建 黄珮珺 张燕 徐娟 韩月 朱善军 曹艳 王鹏[1] 许雨乔 娄鉴芳 史新惠 

机构地区：[1]南京医科大学第一附属医院医学检验学部,210029

出　　处：《中华检验医学杂志》2012年第12期1150-1154,共5页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目（30972821、30901344、30901262）;国家临床重点专科建设项目资助课题;江苏省实验诊断学重点实验室基金资助项目（XK201114）

摘　　要：目的探讨SP70抗原的检测对鉴别癌性胸腔积液和非癌性胸腔积液的诊断价值。方法采用病例对照研究。收集2011年7月至2012年2月经临床确诊的肺癌患者胸腔积液108例和非癌性胸腔积液122例，采用双抗体夹心ELISA法对胸腔积液中SP70抗原进行检测；同时与电化学发光法检测CEA、CYFRA21—1和NSE的结果进行比较；采用直接免疫荧光法对胸腔积液脱落细胞上的SP70抗原进行检测，并与HE染色法的脱落细胞学检测结果进行比较，各组问阳性率比较采用矿检验或Fisher确切概率法。结果癌性胸腔积液患者中SP70、CEA、CYFRA21—1、NSE的阳性率分别为72．2％、58．3％、52．8％和30．6％，显著高于非癌性胸腔积液组（9．8％、13．1％、23．O％和19．7％），SP70、CEA、CYFRA21—1、NSE的特异度分别为90．2％、86．9％、77．0％和80．3％；非小细胞肺癌组的总阳性率显著高于小细胞肺癌组的阳性率（74．3％〉0．0％），差异有统计学意义（P=0．02〈0．05），癌性胸腔积液患者中SP70的阳性符合率高于传统脱落细胞学HE染色的阳性符合率（72．2％〉47．2％），差异有统计学意义（x2=14．03，P〈0．05）。结论测定胸腔积液中及脱落细胞上的SP70抗原，能提高癌性胸腔积液诊断的敏感度和特异度。Objective To investigate the diagnostic value of detection of protein SP70 in differentiating benign and malignant pleural effusion. Methods A case-control study was conducted from July 2011 to February 2012. 108 cases of pleural effusion from patients with clinically proven lung cancers and 122 cases of benign pleural effusion were collected. SP70 was detected by Sandwich ELISA,while CEA, CYFRA21-1, NSE were measured by eleetrochemiluminescence immunoassay for comparison. Meanwhile, protein SP70 on exfoliated cells in pleural effusion was detected by direct immunofluorescence, and was compared with the results of HE staining. The differences between the groups were evaluated by the chisquare test Fisher＇ s exact test. Results Positive rates of SP70, CEA, CYFRA21-1, NSE were 72. 2% , 58.3% ,52. 8% and 30. 6% in malignant plenral effusion, obviously higher than benign pleural effusio （9. 8%, 13.1% , 23.0% and 19.7% ） . The specificity of SP70, CEA, CYFRA21-1, NSE were 90. 2% , 86. 9% ,77.0% and 80. 3% ,NSCLC had significantly higher positive rate than SCLC（74. 3% 〉0. 0% ,P = 0. 02 〈 0. 05）, detection of protein SP70 in malignant pleural effusion had significantly higher coincidence rate than HE staining（72.2% vs 47.2%, X2 = 14. 03 ,P 〈 0. 05）. Conclusion Determination of the protein SPTO in pleural effusion and in exfoliated cells, can improve the sensitivity and specificity of the diagnosis of malignant pleural effusion.

关 键 词：酶联免疫吸附测定 荧光免疫测定 胸腔积液 肿瘤标记 生物学 

分 类 号：R446.1[医药卫生—诊断学]