联合检测胸腹腔积液sCD44V6,CEA,CYFRA21-1,CA199,NSE,CA125对良恶性疾病鉴别诊断价值研究  

Value of Combined Detection of sCD44V6, CEA,CYFRA21-1,CA199,NSE and CA125 in the Differential Diagnosis of Benign and Malignant Pleural and Peritoneal Effusion

作　　者：刘涛 杨燕[2] 刘博 王剑锋 LIU Tao;YANG Yan;LIU Bo;WANG Jian-feng(Tongchuan People’s Hospital,Shaanxi Tongchuan 727031,China;Sun Simiao Hospital of Beijing University ofTraditional Chinese Medicine,Shaanxi Tongchuan 727031,China)

机构地区：[1]铜川市人民医院,陕西铜川727031 [2]北京中医药大学孙思邈医院,陕西铜川727031

出　　处：《现代检验医学杂志》2020年第2期53-55,64,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨可溶性CD44V6(sCD44V6)、血清肿瘤标志物癌胚抗原(CEA)、非小细胞肺癌相关抗原细胞角蛋白19(CYFRA21-1)、糖链抗原199(CA199)、神经原特异烯醇化酶(NSE)和糖链抗原(CA125)联合检测在诊断恶性胸腹腔积液中的应用价值。方法选择2015~2018年结核性胸腹腔积液93例,炎性胸腹腔积液44例,肝硬化腹腔积液39例,共176例(良性胸腹腔积液组),恶性肿瘤患者157例(恶性胸腹腔积液组),应用酶联免疫吸附试验(ELISA)通过标准品绘制标准曲线检测sCD44V6的浓度,采用化学发光法检测胸腹腔积液中CEA,CA199,CA125,CYFRA21-1和NSE水平,绘制ROC曲线并计算曲线下面积(area under curve,AUC)来评价各指标的诊断价值。结果恶性胸腹腔积液中sCD44V6,CEA,CA199,CYFRA21-1和NSE水平明显高于良性胸腹腔积液,两者之间在统计学上有显著性差异(t=12.06~29.33,均P<0.05)。恶性胸腹腔积液异常检出率高于良性胸腹腔积液组,分别为81.53%vs 12.50%,67.28%vs 14.77%,55.41%vs 13.07%,94.90%vs 54.55%,79.62%vs 47.73%,64.33%vs 25.00%,差异均有统计学意义(χ^2=36.11~159.73,均P<0.05);ROC曲线分析sCD44V6,CEA,CA199,CA125,CYFRA21-1,NSE曲线下面积分别为0.816,0.755,0.719,0.784,0.735和0.789,联合检测为0.958;各种检测项目单独检测评价以sCD44V6最好,敏感度为79.61%,特异度为82.92%,联合检测指标敏感度为85.09%,特异度为93.58%。结论 s CD44V6,CEA,CA199,CA125,CYFRA21-1和NSE联合检测对胸腹腔积液良恶性鉴别诊断有重要价值。Objective To investigate the clinical value of combined detection of soluble CD44 V6(sCD44 V6), serum tumor marker carcinoembryonic antigen(CEA), Non-small cell lung cancer associated antigen cytokeratin 19(CYFRA21-1), carbohydrate chain antigen 199(CA199), Neuro-specific enolase(NSE) and carbohydrate chain antigen(CA125) in the diagnosis of malignant pleural and ascites. Methods From 2015 to 2018, 93 cases of tuberculous pleural and peritoneal effusion, 44 cases of inflammatory pleural and peritoneal effusion, 39 cases of hepatocirrhosis, 176 cases(benign pleural and peritoneal effusion group), 157 cases of malignant tumor(malignant pleural and peritoneal effusion group) were selected. The concentration of sCD44 v6 was measured by enzyme-linked immunosorbent assay(ELISA) and the concentration of sCD44 V6 was measured by the standard curve drawn by the standard, and by the chemiluminescence method the level of CEA, CA199, CA125, CYFRA21-1, NSE, ROC curve and area under curve(AUC) were calculated to evaluate the diagnostic value of each index. Results The levels of sCD44 V6, CEA, CA199, CYFRA21-1 and NSE in malignant pleural and ascites were significantly higher than those in benign pleural and ascites(t=12.06~29.33,all P<0.05). The abnormal detection rate of malignant pleur operitoneal effusion was highter than that of benign pleuroperitoneal effusion group were 81.53% vs 12.50%, 67.28% vs 14.77%, 55.41% vs 13.07%, 94.90% vs 54.55%, 79.62% vs 47.73% and 64.33% vs 25.00%, respectively, the difference was statistically significant(χ^2=36.11~159.73, all P<0.05). ROC curve analysis showed that the areas under s CD44 V6, CEA, CA199, CA125, CYFRA21-1 and NSE curves were 0.816, 0.755, 0.719, 0.784, 0.735 and 0.789, respectively, and the joint detection was 0.958. CD44 V6 was the best for all detection items, with sensitivity 79.61%, specificity 82.92%, sensitivity 85.09% and specificity 93.58% respectively. Conclusion s CD44 V6 combined with CEA, CA199, CA125, CYFRA21-1 and NSE detection has great clinical significance

关 键 词：胸腹腔积液 可溶性CD44V6 癌胚抗原 非小细胞肺癌相关抗原 细胞角蛋白19 糖链抗原199 神经原特异烯醇化酶 糖链抗原 良恶性疾病 

分 类 号：R446.19[医药卫生—诊断学]