探讨渗出性胸腔积液ADA、CEA对良恶性胸腔积液的诊断价值  

Diagnostic Value of Exudative Pleural Effusion ADA and CEA in Benign and Malignant Pleural Effusion

作　　者：斯明园 徐大林[1] 江海兵[1] 姜海波 肖洁 SI Mingyuan;XU Dalin;JIANG Haibing;JIANG Haibo;XIAO Jie(Department of Respiratory and Critical Care Medicine,Lujiang People's Hospital,Lujiang,Anhui,China,231500;Department of Respiration,The Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,China,230000)

机构地区：[1]庐江县人民医院呼吸与危重症医学科,安徽庐江231500 [2]安徽医科大学第二附属医院呼吸科,安徽合肥230000

出　　处：《分子诊断与治疗杂志》2021年第1期59-62,共4页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省自然科学基金项目(2008085QH356)。

摘　　要：目的探究渗出性胸腔积液腺苷脱氨酶(ADA)、癌胚抗原(CEA)对良恶性胸腔积液的诊断价值。方法选择2017年1月至2020年8月本院收治的106例渗出性胸腔积液患者,将患者分为恶性组(n=36)和良性组(n=70)。对两组患者胸水ADA、胸水CEA、血清CEA水平进行比较,采用单因素、多因素Logistic回归分析胸水ADA、CEA和血清CEA与良恶性胸腔积液的相关性。运用受试者工作特征(ROC)曲线下面积(AUC)评估渗出性胸腔积液ADA、CEA对良恶性胸腔积液的诊断价值。结果恶性组患者胸水ADA水平明显低于良性组,差异有统计学意义(P<0.05),恶性组患者胸水CEA和血清CEA水平明显高于良性组,差异有统计学意义(P<0.05)。单因素和多因素Logistic回归分析,结果显示,胸水ADA、胸水CEA、血清CEA、胸水CEA/血清CEA>1是影响患者发生恶性胸腔积液的独立危险因素(P<0.05),且联合指标诊断渗出性胸腔积液良恶性胸腔积液的特异性(86.87%)、灵敏度(89.91%)、AUC(0.895)均明显高于单一指标(P<0.05)。结论渗出性胸腔积液ADA、CEA诊断积液良恶性的准确度均较高,但联合指标的灵敏度、准确性和诊断价值更高。Objective To explore the diagnostic value of adenosine deaminase(ADA)and carcinoembryonic antigen(CEA)for benign and malignant pleural effusions in exudative pleural effusion.Methods The 106 patients with exudative pleural effusion admitted to our hospital from January 2017 to August 2020 were selected,and the patients were divided into malignant group(n=36)and benign group(n=70).The levels of pleural fluid ADA,pleural fluid CEA,and serum CEA were compared between the two groups of patients.Single-factor and multivariate Logistic regression was used to analyze the correlation between pleural fluid ADA,CEA,serum CEA and benign and malignant pleural effusion.The receiver operating characteristic(ROC)area under the curve(AUC)was used to evaluate the diagnostic value of exudative pleural effusion ADA and CEA for benign and malignant pleural effusion.Results The ADA level of pleural fluid in the malignant group was significantly lower than that in the benign group,and the difference was statistically significant(P<0.05).The levels of pleural fluid CEA and serum CEA in the malignant group were significantly higher than those in the benign group,and the difference was statistically significant(P<0.05).Univariate and multivariate Logistic regression analysis showed that pleural fluid ADA,pleural fluid CEA,serum CEA,pleural fluid CEA/serum CEA>1 were independent risk factors affecting patients with malignant pleural effusion(P<0.05).And the specificity(86.87%),sensitivity(89.91%)and AUC(0.895)of the combined indicators in diagnosing benign and malignant pleural effusion with exudative pleural effusion were significantly higher than the single indicator(P<0.05).Conclusion Exudative pleural effusion ADA and CEA have higher accuracy in diagnosing benign and malignant effusion,but the sensitivity,accuracy and diagnostic value of the combined indicators are much higher.

关 键 词：渗出性胸腔积液 腺苷脱氨酶 癌胚抗原 良恶性胸腔积液 

分 类 号：R561.3[医药卫生—呼吸系统]