5种肿瘤标志物对恶性胸腔积液诊断价值的初步评估  

Diagnostic value of five tumor markers for malignant pleural effusions

作　　者：韩厅蓄 陈阳阳[2,3] 潘卫[1] 李兴[1] 王国洪[2,3] 徐国宾[2,3] 杨国珍[1] 

机构地区：[1]贵阳医学院,贵阳550004 [2]北京大学肿瘤医院 [3]北京市肿瘤防治研究所检验科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《临床检验杂志》2015年第5期349-353,共5页Chinese Journal of Clinical Laboratory Science

基　　金：贵州省科技合作计划项目(黔科合计省合[2014]7005)

摘　　要：目的探讨癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)、细胞角蛋白19片段(CYFRA21-1)、糖类抗原153(CA153)5种肿瘤标志物对于恶性胸腔积液鉴别诊断的价值。方法连续收集的恶性胸腔积液和良性胸腔积液分别从1家肿瘤专科医院与1家综合医院获得;用电化学发光法检测上述5种肿瘤标志物;选取诊断特异性100%时对应的肿瘤标志物浓度作为切值,评估单项和联合诊断的敏感性。结果恶性胸腔积液组(132例)胸腔积液5种肿瘤标志物水平高于良性组(43例)(P<0.01)。诊断特异性为100%时,CEA、CA153、CYFRA21-1单项诊断恶性胸腔积液的阳性率均大于30%,CEA检测的敏感性最高达64.4%,CA199、CA125单项诊断的敏感性较低,均小于30%(分别为28.0%、15.9%);CEA/CA153和CEA/CYFRA21-1两两联合和3项联合检测诊断恶性胸腔积液的敏感性分别为71.2%、74.2%、76.5%。结论联合检测胸腔积液CEA、CYFRA21-1和CA153对于恶性胸腔积液诊断具有良好性能。Objective To investigate the diagnostic value of cancer embryonic antigen（ CEA）,carbohydrate antigen 199（ CA199）,carbohydrate antigen 125（ CA125）,cytokeratin 19 fragment（ CYFRA21-1） and carbohydrate antigen 153（ CA153） in malignant pleural effusions. Methods The samples of malignant and benign pleural effusions were collected from a cancer hospital and a general hospital respectively. The above five tumor markers were tested by electrochemical luminescence technique. The corresponding concentrations of tumor markers with 100 percent of diagnostic specificity were chosen as cutoff values. The diagnostic sensitivities of single and joint detection were evaluated. Results The levels of five tumor markers in malignant pleural effusions（ n = 132） were significantly higher than those in benign pleural effusions（ n = 43）（ P〈0. 01）. The sensitivities of single detection of CA199 and CA125 for malignant pleural effusions were 28. 0% and 15. 9% respectively. The diagnostic sensitivity of CEA was 64. 4%,which was higher than that of other markers. The diagnostic sensitivity of CEA combined with CA153 was 71. 2% and the sensitivity of CYFRA21-1 combined with CEA was 74. 2%. The diagnostic sensitivity of triplet detection of CEA,CYFRA21-1 and CA153 was 76. 5%. Conclusion The combined detection of CEA,CYFRA21-1 and CA153 should be the most sensitive for diagnosis of malignant pleural effusions.

关 键 词：胸腔积液 肿瘤标志物 CEA CA199 CA125 CYFRA21-1 CA153 

分 类 号：R446[医药卫生—诊断学]