ESM-1和CEA联合检测在鉴别良恶性胸腔积液中的价值  

Diagnostic significance of combining determination ESM-1 with CEA level in differentiating malignant pleural effusion from tuberculous pleural effusion

作　　者：陆国军[1] 张宇[1] 解卫平[2] 曾晓宁[2] 孔辉[2] 魏永越[3] 

机构地区：[1]东南大学医学院附属南京胸科医院呼吸科,江苏南京210029 [2]南京医科大学第一附属医院呼吸科,江苏南京210029 [3]南京医科大学公共卫生学院统计学系,江苏南京211166

出　　处：《南京医科大学学报（自然科学版）》2017年第1期77-80,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金(81273571);南京市胸科医院青年人才基金

摘　　要：目的:探讨胸腔积液中细胞内皮特异因子-1(malignant pleural effusion,ESM-1)、癌胚抗原(carcino embryonie antigen,CEA)联合检测对肺癌所致恶性胸腔积液(malignant pleural effusion,MPE)和结核性胸腔积液(tuberculous pleural effusion,TPE)的鉴别诊断价值。方法:收集110例胸腔积液患者,其中肺癌伴MPE 65例,TPE 45例,分别采用ELISA法和化学发光法对两组患者胸腔积液组的ESM-1和CEA水平进行测定,根据受试者工作曲线(ROC)计算临床诊断界值,并对结果进行统计分析。结果:MPE中ESM-1和CEA的水平明显高于TPE组,差异有统计学意义(P均<0.001)。ESM-1取19.58 ng/m L时,诊断MPE的敏感度、特异度和准确性分别为81.50%、84.60%、82.73%;CEA取8.52 ng/m L时,诊断MPE的敏感度、特异度和准确性分别为73.80%、95.60%和82.73%。二者联合检测的敏感度、特异度和准确性为83.1%、93.3%和82.73%。结论:MPE患者胸腔积液中ESM-1显著增高,ESM-1对MPE有一定的诊断价值,联合检测ESM-1和CEA可进一步提高MPE诊断敏感度。Objective： To investigate the diagnostic value of combining determination of ESM-1 and CEA levels in differentiating tuberculous（TPE） from malignant pleural effusion（MPE） caused by lung cancer. Methods： Totally 65 NSCLC patients with MPE and 45 patients with TPE were enrolled into this study. The ESM-1 level in pleural effusion was tested by ELISA and CEA levels were tested by the chemiLuminescence method. All results were analyzed by the statistical method. Results： The levels of ESM-1 and CEA in MPE was significantly higher than those in TPE（P〈0.001 ）. The sensitivity of ESM-1 testing for diagnosing MPE was 81.5%, the specificity was 84.60% and the accuracy was 82.73%. The sensitivity of CEA testing was 73.80%, the specificity was 95.60%, and the overall accuracy was 82.73%. The sensitivity of the combined testing was 83.10%, the specificity was 96.30%, and the overall accuracy was 82.73%. The sensitivity and the overall accuracy of combined testing were higher than those by ESM-1 and CEA testing single. Conclusion： MPE presents higher ESM-1 concentration than TPE does,and determination of ESM-1 is useful to differentiate MPE from TPE. The combined testing of ESM-1 with CEA can increase the sensitivity of diagnosis of MPE.

关 键 词：ESM-1 CEA 胸腔积液 鉴别诊断 

分 类 号：R730.43[医药卫生—肿瘤]