内科胸腔镜联合胸腔积液及外周血CEA、CYFRA21-1、NSE鉴别诊断不明原因胸腔积液的价值  

The value of medical thoracoscopy combined with pleural effusion and peripheral blood CEA, CYFRA21-1, NSE in differential diagnosis of unexplained pleural effusion

作　　者：黄江民 HUANG Jiang-min(Department of Respiratory and Critical Care,Wuhan Yangtze River Shipping General Hospital,Wuhan 430000,China)

机构地区：[1]武汉市长江航运总医院呼吸与危重症科,湖北武汉430000

出　　处：《吉林医学》2023年第3期629-632,共4页Jilin Medical Journal

基　　金：湖北省卫生健康委员会联合基金项目[项目编号:WJ2019H37]。

摘　　要：目的:研究内科胸腔镜联合胸腔积液及癌胚抗原(CEA)、细胞角蛋白片段19(CYFRA21-1)、神经特异性烯醇化酶(NSE)对不明原因胸腔积液的诊断价值。方法:选取不明原因胸腔积液患者57例为研究对象,以胸膜活检检查结果为金标准,分析胸腔积液及外周血中患者不同病因的CEA、CYFRA21-1、NSE水平以及胸腔镜分别与胸腔积液及外周血联合检测的诊断效能。结果:57例患者中,胸膜活检检测出恶性、良性分别为37例、20例,检出率分别为64.91%、35.09%;恶性中肺癌、其他恶性肿瘤分别27例、10例,检出率分别为72.97%、27.03%;良性中炎性、结核性分别9例、11例,检出率分别为45.00%、55.00%;良恶性胸腔积液及外周血中CEA、CYFRA21-1、NSE水平比较,良性差异无统计学意义(P>0.05),恶性均升高,差异有统计学意义(P<0.05);胸腔镜联合胸腔积液诊断效能各指标均高于胸腔镜单独检测及其与胸腔积液联合检测。结论:内科胸腔镜联合胸腔积液CEA、CYFRA21-1、NSE诊断价值更高。Objective To study the diagnostic value of medical thoracoscopy combined with pleural effusion and CEA, CYFRA21-1 and NSE in the diagnosis of unexplained pleural effusion.Method Fifty-seven patients with unexplained pleural effusion were selected. The results of pleural biopsy were used as the gold standard to analyze pleural effusion and peripheral blood levels. The levels of CEA, CYFRA21-1 and NSE in patients with different etiologies and the diagnostic efficacy of combined detection of thoracoscopy with pleural effusion and peripheral blood, respectively.Results Among the 57 patients, 37 and 20 were malignant and 20 benign, respectively, and the detection rate was 64.91% and 35.09%, respectively;27 and 10 were malignant lung cancer and other malignant tumors, respectively, and the detection rate was 72.97%, 27.03%,respectively;9 and 11 cases of benign and moderate inflammatory and tuberculous cases, respectively, the detection rates were 45.00% and 55.00%, respectively;the level of CEA, CYFRA21-1 and NSE in benign and malignant pleural effusion and peripheral blood were compared, and there were benign differences, there was no significant difference(P>0.05), and the malignant tumors were all increased(P<0.05);The diagnostic efficacy of VATS combined with pleural effusion is higher than that of VATS alone and combined with pleural effusion.Conclusion Medical thoracoscopy combined with pleural effusion CEA, CYFRA21-1 and NSE has higher diagnostic value.

关 键 词：内科胸腔镜 胸腔积液 癌胚抗原 诊断价值 

分 类 号：R561.3[医药卫生—呼吸系统]