胸水生化指标联合肿瘤标志物在肺癌恶性胸水鉴别诊断中的应用价值  

Application value of hydrothorax biochemical indexes combined with tumor markers in differentially diagnosing malignant pleural effusion of lung cancer

作　　者：邹光美 黄朝任 吴博文[1] 陈武[1] 周传林[3] 王超 ZOU Guang-mei;HUANG Chao-ren;WU Bo-wen(Department of Clinical Laboratory,the First People′s Hospital of Yulin City,Guangxi 537000,China)

机构地区：[1]玉林市第一人民医院检验科,广西537000 [2]玉林市中医医院检验科,广西537000 [3]玉林市第一人民医院呼吸内科,广西537000

出　　处：《中国临床新医学》2018年第9期895-899,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨胸水生化指标联合肿瘤标志物在肺癌患者恶性胸水鉴别诊断中的应用价值。方法选取2016-01~2017-12该院住院的70例肺癌患者为研究对象,并选择同期住院的其他呼吸系统疾病(肺炎、慢性阻塞性肺疾病)并伴胸腔积液的患者70例作为非肺癌对照组,测定胸水生化5项、胸水及血清肿瘤标志物水平变化,比较两组指标差异。结果肺癌组胸水的TP、FET、LDH、胸水LDH/血清LDH比值、CEA、CA19-9、CA153、CA125、CYFRA21-1水平均显著高于对照组(P <0. 01)。肺癌组血清CA19-9、CA153、CA125及CYFRA21-1水平均显著高于对照组(P <0. 01)。肺癌组肿瘤标志物项目胸水ROC曲线下的面积> 0. 8的有CEA、CA153、CYFRA21-1,而血清ROC曲线下的面积> 0. 8的仅有CYFRA21-1。结论胸水生化TP、FET、LDH、胸水LDH/血清LDH比值及联合其血清肿瘤标志物可以作为肺癌恶性胸水的鉴别诊断指标,其中CYFRA21-1鉴别肺癌恶性胸水的临床价值最高。Objective To explore the application value of hydrothorax biochemical indexes combined with tumor markers in differentially diagnosing malignant pleural effusion of lung cancer. Methods 70 cases of lung cancer were selected as the research objects（the lung cancer group） in our hospital from January 2016 to December 2017, and 70 patients with other respiratory diseases（pneumonia, chronic obstructive pulmonary disease） and pleural effusion were selected as the control group during the same period. The 5 items of hydrothorax biochemistry, pleural effusion and serum tumor marker levels were compared between the two groups. Results The levels of TP, FET, LDH, pleuval LDH/serum LDH ratio, CEA, CA19-9, CA153, CA125 and CYFRA21-1 in pleural effusion of the lung cancer group were significantly higher than those of the control group（P〈0.01）. The serum levels of CA19-9, CA153, CA125, and CYFRA21-1 in the lung cancer group were significantly higher than those in the control group（P〈0.01）. In the tumor markers of the lung cancer group, the areas under ROC curve were greater than 0.8 with CEA, CA153, and CYFRA21-1 in the pleural effusion, while the ROC curve with an area greater than 0.8 was only CYFRA21-1 in the serum. Conclusion The biochemical indicators of TP, FET, LDH and pleural LDH/serum LDH ratio in pleural effusion and the serum tumor markers can be used as differential diagnosis indexes for malignant pleural effusion of lung cancer, and CYFRA21-1 has the highest clinical value in distinguishing malignant pleural effusion from lung cancer.

关 键 词：肺癌 恶性胸水 生化指标 肿瘤标志物 

分 类 号：R445[医药卫生—影像医学与核医学]