脱落细胞学与肿瘤标志物检测在恶性胸腔积液诊断中的价值  

The value of exfoliative cytology and tumor marker detection in the diagnosis of malignant pleural effusion

作　　者：王健[1] 刘圣勋 任金来[1] WANG Jian;LIU Shengxun;REN Jinlai(Department of Clinical Laboratory,Binzhou Medical University Hospital,Shandong,Binzhou 256600,China)

机构地区：[1]滨州医学院附属医院检验科,山东滨州256600

出　　处：《中国医药科学》2024年第19期136-139,共4页China Medicine And Pharmacy

基　　金：滨州医学院科技计划项目(BY2021KJ39)。

摘　　要：目的研究脱落细胞学与肿瘤标志物检测在诊断恶性胸腔积液中的价值。方法回顾性分析2021年12月至2023年3月滨州医学院附属医院收治的32例恶性胸腔积液患者及45例良性胸腔积液患者的临床资料,均进行脱落细胞学检查,检测并比较两组患者胸腔积液中癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)表达水平;分析各指标单项检测及与脱落细胞学联合检测的诊断效能评价。结果脱落细胞检查阳性率为65.6%。CEA、NSE、CYFRA21-1水平在恶性胸腔积液组高于良性胸腔积液组,差异有统计学意义(P<0.05)。脱落细胞形态学检查联合CEA、NSE、CYFRA21-1诊断恶性胸腔积液的灵敏度为90.6%,准确度为83.1%,高于CEA、NSE、CYFRA21-1单项检测结果,差异有统计学意义(P<0.05)。漏诊率为9.3%,低于CEA、NSE、CYFRA21-1单项检测结果,差异有统计学意义(P<0.05)。联合检测特异度、误诊率与CEA、NSE、CYFRA21-1单项检测结果比较,差异无统计学意义(P>0.05)。结论脱落细胞学检查是鉴别恶性胸腔积液的有效方法,细胞形态学与胸腔积液肿瘤标志物联合检测可显著提高鉴别诊断恶性胸腔积液的灵敏度和准确度,减少漏诊率。Objective To study the value of exfoliative cytology and tumor marker detection in the diagnosis of malignant pleural effusion.Methods A retrospective analysis was conducted on the clinical data of 32 patients with malignant pleural effusion and 45 patients with benign pleural effusion admitted to the Binzhou Medical University Hospital from December 2021 to March 2023.Exfoliative cytology was performed on all patients,and the expression levels of carcinoembryonic antigen(CEA),neuron specific enolase(NSE),and cytokeratin 19 fragment(CYFRA21-1)in the pleural effusion of the two groups of patients were detected and compared;Analysis was made on the diagnostic efficacy evaluation of individual detection of various indicators and combined detection with exfoliative cytology.Results The positive rate of exfoliated cell test was 65.6%.The levels of CEA,NSE,and CYFRA21-1 were higher in the malignant pleural effusion group than in the benign pleural effusion group,and the differences were statistically significant(P<0.05).The sensitivity and accuracy of combined exfoliative cell morphology examination with CEA,NSE,and CYFRA21-1 in diagnosing malignant pleural effusion were 90.6%and 83.1%,which were higher than the single detection results of CEA,NSE,and CYFRA21-1,and the difference was statistically significant(P<0.05).The missed diagnosis rate was 9.3%,which was lower than the single test results of CEA,NSE,and CYFRA21-1,and the difference was statistically significant(P<0.05).There was no statistically significant difference(P>0.05)in the specificity and misdiagnosis rate of joint testing compared to the results of single tests such as CEA,NSE,and CYFRA21-1.Conclusion Exfoliative cytology examination is an effective method for distinguishing malignant pleural effusion.The combined detection of cell morphology and tumor markers in pleural effusion can significantly improve the sensitivity and accuracy of differential diagnosis of malignant pleural effusion,and reduce the missed diagnosis rate.

关 键 词：脱落细胞学 肿瘤标志物 恶性胸腔积液 联合检测 

分 类 号：R446.19[医药卫生—诊断学]