肿瘤标志物水平对脱落细胞性质不明确的良恶性胸腔积液的辅助诊断价值  

The auxiliary diagnostic value of tumor markers level in benign and malignant pleural effusion when the nature of exfoliated cells is unclear

作　　者：陈文波 徐茂义 宋斌斌 CHEN Wenbo;XU Maoyi;SONG Binbin(Graduate School of Bengbu Medical College,Anhui Bengbu 233030,China;Department of Oncology,The First Hospital of Jiaxing,Zhejiang Jiaxing 314000,China)

机构地区：[1]蚌埠医学院研究生院,安徽蚌埠233030 [2]嘉兴市第一医院肿瘤内科,浙江嘉兴314000

出　　处：《现代肿瘤医学》2023年第23期4367-4371,共5页Journal of Modern Oncology

基　　金：浙江省嘉兴市科技计划项目(编号:2019AY32030)。

摘　　要：目的:探讨[癌胚抗原(CEA)、糖链抗原CA199、糖链抗原CA242、糖链抗原CA50、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]5项胸腔积液肿瘤标志物水平对脱落细胞性质不明确时良恶性胸腔积液的辅助诊断价值。方法:收集2020年01月至2022年06月261例胸腔积液患者,其中,良性胸腔积液为良性组88人,恶性胸腔积液根据脱落细胞学性质分为脱落细胞阳性组93人,脱落细胞阴性组80人。比较3组胸腔积液中5项肿瘤标志物的水平及阳性率,并分析不同肿瘤标志物单独与联合的鉴别能力。结果:3组中5项肿瘤标志物水平均存在统计学差异(P<0.01)。其中胸腔积液脱落细胞学阳性组水平均高于阴性组及良性组(P<0.01),阴性组中仅CEA与良性组差异有统计学意义(P<0.01)。胸腔积液脱落阳性组CEA和CYFRA21-1高于血清组(P<0.01);脱落阴性组CYFRA21-1高于血清组(P<0.01)。3组中除CYFRA21-1阳性率均存在统计学差异(P<0.01)。其中胸腔积液脱落阳性组CEA、CA199、CA242、CA50阳性率高于阴性和良性组(P<0.01);胸腔积液脱落阴性组CEA、CA199、CA242、CA50阳性率高于良性组(P<0.01);3组CYFRA21-1阳性率比较无统计学差异(P>0.05)。胸腔积液脱落阳性及阴性组CEA诊断效能均优于其它单独诊断;脱落阳性组CEA+CYFRA21-1,脱落阴性组CEA+CA50标志物联合检测可以提高鉴别能力。结论:胸腔积液肿瘤标志物水平对脱落细胞性质不明确时胸腔积液的良恶性有重要辅助诊断价值。Objective:To investigate the value of five pleural effusion tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen CA199,carbohydrate antigen CA242,carbohydrate antigen CA50,cytokeratin 19 fragment antigen 21-1(CYFRA21-1)]in the diagnosis of benign and malignant pleural effusion when the exfoliated cells were not clear.Methods:A total of 261 patients with pleural effusion from January 2020 to June 2022 were collected,including 88 patients with benign pleural effusion,93 patients with malignant pleural effusion,and 80 patients with negative exfoliated cells.The levels and positive rates of five tumor markers in pleural effusion of the three groups were compared,and the differential ability of different tumor markers alone and in combination was analyzed.Results:There were significant differences in the levels of five tumor markers among the three groups(P<0.01).The level of CEA in positive group was higher than that in negative group and benign group(P<0.01).The level of CEA in negative group was higher than that in benign group(P<0.01).The levels of CEA and CYFRA21-1 in the pleural effusion shedding positive group were higher than those in the serum positive group(P<0.01).The level of CYFRA21-1 in seronegative group was higher than that in seronegative group(P<0.01).There were significant differences in the positive rate of CYFRA21-1 among the three groups(P<0.01).The positive rates of CEA,CA199,CA242 and CA50 in the pleural effusion positive group were higher than those in the negative and benign groups(P<0.01).The positive rates of CEA,CA199,CA242 and CA50 in the negative group were higher than those in the benign group(P<0.01).There was no significant difference in the positive rate of CYFRA21-1 among the three groups(P>0.05).The diagnostic efficacy of CEA in pleural effusion shedding positive and negative groups was better than that of other groups alone.The combined detection of CEA+CYFRA21-1 in the dropped positive group and CEA+CA50 in the dropped negative group can improve the differentiation ab

关 键 词：肺癌 胸腔积液 脱落细胞学 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]