良恶性胸腔积液的临床特征及预测因素分析  

Clinical characteristics and predictors of malignant pleural effusion and non-malignant pleural effusion

作　　者：秦湧[1] 朱祎娜 崔进[1] 

机构地区：[1]南京医科大学第二附属医院呼吸内科,江苏南京210011

出　　处：《现代肿瘤医学》2015年第9期1236-1238,共3页Journal of Modern Oncology

摘　　要：目的:对比分析良恶性胸腔积液的临床特征,筛选恶性胸腔积液可能的预测因素。方法:收集良性胸腔积液患者30人和恶性胸腔积液患者32人的临床资料,分析胸腔积液及血液学相关指标(胸腔积液物理性状、胸腔积液和血液学生化、肿瘤标志物)。结果:恶性胸腔积液患者的年龄明显高于良性胸腔积液患者,但二者在性别分布上无差异。恶性胸腔积液的乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)、γ-干扰素(γ-IFN)显著低于良性胸腔积液,而癌胚抗原(CEA)、糖类抗原(CA19-9)、神经特异性烯醇化酶(NSE)显著高于良性胸腔积液(P均<0.05)。两组患者血液LDH、ADA、CEA、CA19-9的差异也具有统计学意义。条件Logistic回归分析发现CEA>10ng/ml、血性胸腔积液、ADA<15U/ml、CA19-9>20U/ml为恶性胸腔积液的预测因素。结论:非肿瘤标志物(如胸水颜色、ADA值)也有助于胸腔积液性质的判断。恶性胸腔积液的预测作用由大到小依次为CEA、血性胸腔积液、ADA、CA19-9。Objective：To compare the clinical characteristics between malignant pleural effusion（MPE）and non- malignant pleural effusion（NMPE）and the predictive factors of MPE. Methods：A total of 32 MPE patients and 30 NMPE patients were enrolled in this study. The parameters（physical characteristics,biochemical index and tumor markers）of pleural effusion and plasma were analyzed. Results：The MPE patients were older than NMPE patients. There were remarkably lower LDH,ADA and γ - IFN in MPE than those in NMPE. The MPE patients had a signifi-cantly higher CEA,CA19 - 9,NSE in both pleural effusion and plasma than NMPE patients. CEA 〉 10ng/ ml,bloody pleural effusion,ADA 〈 15U/ ml and CA19 - 9 〉 20U/ ml were the predictive factors for MPE. Conclusion：The non -tumor markers such as ADA are of value to identify the nature of pleural effusion. The predictive power for MPE are CEA,bloody pleural effusion,ADA and CA19 - 9 in sequence.

关 键 词：胸腔积液 肺癌 肿瘤标志物 

分 类 号：R734.3[医药卫生—肿瘤]