聚合酶链反应配合腺苷脱氨酶和癌胚抗原检测鉴别诊断结核性和癌性胸腔积液的价值  

Value of enzyme chain reaction combined with adenosine deaminase and carcinoembryonic antigen test in the differential diagnosis of tuberculous and cancerous pleural effusion

作　　者：翁文婕 吴燕琴[2] 方炳雄[1] 罗慎颖 张俊贤 洪妙玲 WENG Wenjie;WU Yanqin;FANG Bingxiong;LUO Shenying;ZHANG Junxian;HONG Miaoling(Precision Medicine Center,Puning People's Hospital,Guangdong Province,Puning515300,China;Department of Clinical Laboratory,Puning People's Hospital,Guangdong Province,Puning515300,China;Department of Infectious Disease,Puning People's Hospital,Guangdong Province,Puning515300,China)

机构地区：[1]广东省普宁市人民医院精准医学中心,广东普宁515300 [2]广东省普宁市人民医院检验科,广东普宁515300 [3]广东省普宁市人民医院传染科,广东普宁515300

出　　处：《中国当代医药》2023年第27期114-117,共4页China Modern Medicine

基　　金：广东省揭阳市卫生健康局医学科学技术研究立项项目。

摘　　要：目的分析聚合酶链反应配合腺苷脱氨酶和癌胚抗原检测对鉴别诊断结核性和癌性胸腔积液的价值。方法选取2018年1月至2022年1月普宁市人民医院收治的40例胸腔积液患者作为研究对象,根据病理检查结果分为观察组(癌性胸腔积液,共20例)和对照组(结核性胸腔积液,共20例)。两组患者均行胸腔积液样本采集,采用聚合酶链反应测量胸腔积液结核分枝杆菌DNA(TB-DNA)阳性率,采用酶速率法检测腺苷脱氨酶(ADA),采用电化学发光法测量癌胚抗原(CEA)。比较两组患者检测结果的差异,并比较不同指标与三个指标联合应用的敏感度、特异度、准确度的差异。结果观察组胸腔积液TB-DNA阳性率以及ADA含量低于对照组,差异有统计学意义(P<0.05);观察组胸腔积液CEA含量高于对照组,差异有统计学意义(P<0.05);胸腔积液TB-DNA联合ADA及CEA检查的敏感度与准确度高于单独胸腔积液TB-DNA、ADA、CEA检查,差异有统计学意义(P<0.008);胸腔积液TB-DNA联合ADA及CEA检查的特异度高于单独胸腔积液TB-DNA、ADA检查,差异有统计学意义(P<0.008);胸腔积液TB-DNA联合ADA及CEA检查与胸腔积液CEA的特异度比较,差异无统计学意义(P>0.05)。结论胸腔积液TB-DNA联合ADA及CEA检查在鉴别诊断结核性与癌性胸腔积液中具有较高的敏感度与准确度,可推广使用。Objective To analyze the value of polymerase chain reaction combined with adenosine deaminase and carcinoembryonic antigen detection in differential diagnosis of tuberculous and cancerous pleural effusion.Methods A total of 40 patients with pleural effusion treated in Puning People's Hospital from January 2018 to January 2022 were selected as the study objects,and they were divided into observation group(20 cases of cancerous pleural effusion)and control group(20 cases of tuberculous pleural effusion)according to pathological examination results.Pleural effusion samples were collected in both groups.The positive rate of mycobacterium tubercle bacillus DNA(TB-DNA)in pleural effusion was measured by polymerase chain reaction,adenosine deaminase(ADA)was detected by enzyme rate method,and carcinoembryonic antigen(CEA)was measured by electrochemical luminescence method.The differences in test results between the two groups were compared,and the differences in sensitivity,specificity and accuracy of different indicators combined with the three indicators were compared.Results The positive rates of TB-DNA and ADA content of pleura in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).CEA content in pleural fluid of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).The sensitivity and accuracy of TB-DNA combined with ADA and CEA in pleural fluid were higher than those of TB-DNA,ADA and CEA alone,and the differences were statistically significant(P<0.008).The specificity of TB-DNA combined with ADA and CEA in pleural fluid was higher than that of TB-DNA and CEA in pleural fluid alone,and the differences were statistically significant(P<0.008),while the specificity of TB-DNA combined with ADA and CEA in pleural fluid compared with CEA in pleural fluid alone was not statistically significant(P>0.05).Conclusion Pleural effusion TB-DNA combined with ADA and CEA has high sensitivity and accura

关 键 词：聚合酶链反应 腺苷脱氨酶 癌胚抗原 结核性胸腔积液 癌性胸腔积液 鉴别诊断 

分 类 号：R730.43[医药卫生—肿瘤]