放射免疫洁、免疫细胞化学法检测癌胚抗原在胸水鉴别诊断中的应用

本文用放射免疫法（ＲＩＡ）测定良、恶性胸水各３０例的癌胚抗原（ＣＥＡ）的含量，并用过氧化酶—抗—过氧化酶法（ＰＡＰ法）对胸水中脱落细胞行抗ＣＥＡ染色的免疫细胞化学研究。ＲＩＡ测定恶性胸水中ＣＥＡ值为２５．１５±８．８８ｎｇ／ｍｌ，良性胸水中ＣＥＡ值为５．２４±２．１５ｎｇ／ｍｌ，有高度显著性差异（Ｐ＜０．００１）；以２０ｎｇ／ｍｌ为阳性界限，其敏感性为４０％，特异性为１００％，正确诊断率为７０％。ＰＡＰ法敏感性为７３．３％，特异性为９６．７％，正确诊断率为８５％。结果提示两法检测ＣＥＡ对良恶性胸水的鉴别诊断都有一定的实用价值，但ＰＡＰ较ＲＩＡ法敏感性高。     

肿瘤相关抗原CA50监测泌尿男生殖系统恶性肿瘤的临床意义

作者用免疫放射测定法（ＩＲＭＡ）检测了８４例泌尿男生殖系统恶性肿瘤病人，４８例良性疾患病人及３５例正常人的血清ＣＡ５０值。结果发现，恶性肿瘤病人的血清ＣＡ５０值显著高于良性疾患病人及正常人（Ｐ＜０．０５～０．０１）。若以１７ｕ／ｍｌ为诊断界值，其阳性率分别为：肾细胞癌５５％（１１／２０），肾盂及输尿管癌８７％（７／８），膀胱癌６５％（３０／４６），男生殖系恶性肿瘤７０％（７／１０）。其敏感性为６６％（５５／８４），特异性为８８％（４２／４８）。ＣＡ５０水平的测定还能用于对疗效的评价及对肿瘤复发的预测。     

CA_（19－9）和CA_（50）对消化道肿瘤的诊断价值

本文作者分别检测了１０６例消化道良性疾病患者及７８例癌肿患者血清ＣＡ１９－９和ＣＡ５０的含量，分析了肝脏、胰腺、胃及结直肠４组良，恶性疾病患者血清含量的变化及其临床意义。结果１０６例良性疾病ＣＡ１９－９和ＣＡ５０的上限值分别为３４ｕ／ｍｌ和１４ｕ／ｍｌ（ｘ±２Ｓ），其诊断的敏感性和特异性如下：ＣＡ１９－９对原发性肝癌分别为７５．０％和８６．９％，对胰腺癌分别为９１．７％和１００％，对胃癌分别为５５．６％和１００％；ＣＡ５０对原发性肝癌分别为５５．０％和７８．３％，对胰腺癌分别为９１．７％和１００％，对胃癌分别为５５．６％和１００％。ＣＡ１９－９与ＣＡ５０有高中度相关性，肝癌ｒ＝０．６２、胰腺癌ｒ＝０．６７、胃癌ｒ＝０；９０，Ｐ值均＜０．０１。因此认为ＣＡ１９－９和ＣＡ５０对消化道良、恶性疾病的诊断、鉴别有较高的临床价值，并对消化道癌肿有否转移及胃癌根治术是否彻底、术后有否复发的判断均具有一定临床意义。     

腺苷脱氨酶与癌胚抗原在恶性胸腔积液的诊断价值

测定了３８例恶性胸腔积液及３４例结核性胸水的腺苷脱氨酶（ＡＤＡ）与癌胚抗原（ＣＥＡ）在胸水、血清中水平及胸水／血清值。结果恶性组胸水ＡＤＡ值明显低于结核组（Ｐ＜０．０００５），ＡＤＡ胸水／血清值低于结核组（Ｐ＜０．０００５）；恶性组胸水ＣＥＡ水平明显高于结核组（Ｐ＜０．０００５），ＣＥＡ胸水／血清值恶性组亦明显高于结核组（Ｐ＜０．０５）。胸水ＡＤＡ水平对诊断恶性胸腔积液的敏感性为９６．１５％，符异性９１．６７％；ＣＥＡ的敏感住７０．８３％，特异性为８７．５０％。综合分析胸水的ＡＤＡ、ＣＥＡ水平及胸水／血清值，有助于对恶性胸腔积液的诊断。     

血清糖链抗原50对胃癌的诊断价值

观察５４例正常人，６２例胃癌及３２例胃良性疾病病人血清糖链抗原５０（ＣＡ５０）含量。结果表明：胃癌病人血清ＣＡ５０含量显著高于正常人和胃良性疾病病人（Ｐ均＜０．００１）；且胃癌早期即有明显增高，晚期增高更为显著。行根治术后其血清含量较术前显著降低而接近正常（Ｐ＜０．０１）；术后复发者又再增高，行姑息术或化疗后较治疗前略降低。若以血清ＣＡ５０９ｋＵ／Ｌ为阳性诊断界值，对胃癌诊断的敏感性为８２．３％，特异性为９３．８％，阳性预计值为９２．７％，胃良性疾病的假阳性率为６．３％，正常人假阳性率为３．７％。癌性腹水病人血清和腹水ＣＡ５０含量均显著高于良性腹水病人（Ｐ均＜０．００１）。提示血清和腹水ＣＡ５０含量检测在胃癌和癌性腹水的诊断，尤其是胃癌的早期诊断和治疗后监测中有一定临床实用价值。     

ADA,CEA和CA19—9联合检测对老年结核和肿瘤性胸水的鉴别诊断价值

探讨腺苷脱氨酶（ＡＤＡ）、癌胚抗原（ＣＥＡ）和癌抗原１９－９（ＣＡ１９－９）对老年结核和肿瘤性胸水的鉴别诊断价值。方法检测经病理确诊的≥６０岁的３２例结核性胸膜炎和２０例癌性胸水中的ＡＤＡ、ＣＥＡ和ＣＡ１９－９含量。结果单项检测：ＡＤＡ诊断结核性胸膜炎的敏感性为５７．３％，特异性为９５％，准确度为９５％；ＣＥＡ和ＣＡ１９－９诊断肿瘤性胸水的敏感性分别为６５％和７０％，特异性为８８％和９４％，准确度为７５％和８８％。联合检测：以三项同时符合结核或癌性胸水为诊断依据时，结核和癌性胸水的敏感性分别为５０％和６５％，特异性和准确度均为１００％。结论ＡＤＡ、ＣＥＡ和ＣＡ１９－９联合检测对老年结核与癌性胸水有较高的鉴别诊断价值。     

CEA与CA—50联合测定在胃肠道恶性肿瘤中的临床应用

目的：探讨 Ｃ Ｅ Ａ、 Ｃ Ａ５０ 联合测定在胃肠道恶性肿瘤诊断、疗效观察，术后监测的价值。方法： 分别测定正常人、良性疾病患者和４７０ 例胃肠道恶性肿瘤患者以及６３ 例胃肠道恶性肿瘤术后患者的血清 Ｃ Ｅ Ａ、 Ｃ Ａ５０ 水平。结果：胃癌患者 Ｃ Ｅ Ａ 阳性率为６０ ．００ ％ ， Ｃ Ａ５０ 阳性率为６８ ．００ ％ ，联合测定阳性率为８３ ．３３ ％ ；大肠癌患者的 Ｃ Ｅ Ａ 阳性率为７０ ．３１ ％ ， Ｃ Ａ５０ 阳性率为７５ ．００ ％ ，联合测定阳性率为８８ ．１２ ％ 。随访６３ 例术后患者中，有４１ 例患者血清可见 Ｃ Ｅ Ａ 或 Ｃ Ａ５０ 升高，在血清学变化的３ ～１２ 月内被临床证实转移或复发。结论：联合测定 Ｃ Ｅ Ａ、 Ｃ Ａ５０ 不仅可提高胃肠道恶性肿瘤的阳性诊断率，还可进行疗效观察及术后监测。     

测定胃癌术后患者血清CEA,CA50及Cu／Zn比值的临床意义

作者测定了３０例胃癌术后无瘤患者及３４例胃癌术后复发或转移患者血清中的ＣＥＡ、ＣＡ_（５０）及Ｃｕ／Ｚｎ比值，并对２０例术后无癌残留患者进行随访观察。结果：术后复发转移组的ＣＥＡＣＡ_（５０）及Ｃｕ／Ｚｎ比值均显著高于术后无瘤组（Ｐ＜０．０１）；术后复发转移组中ＣＡ_（５０）、ＣＥＡ及ＣＵ／Ｚｎ比值阳性率分别为５８．８％、４７．０％、４７．０％；术后随访组中，三种指标对胃癌术后转移总的阳性预测率为７５．０％（６／８）。揭示ＣＡ_（５０）、ＣＥＡ及Ｃｕ／Ｚｎ比值可用于胃癌术后患者复发及转移的监测。三者比较，ＣＡ_（５０）敏感性最高，而ＣＥＡ特异性最好。联合检测可提高阳性率。     

胸水肿瘤标志物测定的临床诊断价值

［目的］观察胸水中肿瘤标志物测定值对临床诊断的价值。［方法］分别测定４６例胸腔积液患者的血清与胸水肿瘤标志物（ＣＥＡ、ＮＳＥ、 ＣＡ２４２、 ＣＹＦＲＡ２１－１）含量,其中癌性积液２８例,良性积液１８例。［结果］发现胸水中肿瘤标志物含量明显高于血清水平;ＣＥＡ、ＮＥＳ、ＣＡ２４２三者联合应用在胸水中敏感性高达９２．８％,特异性９６．２％,而血清中相应为７５．１％,８７．５％;ＣＹＦＲＡ２１－１在良性组中虽阳性率较高,但数值明显低于癌性积液组（Ｐ＜０．０１）。［结论］测定胸水肿瘤标志物对恶性积液的诊断具有临床应用价值。     

CA-50、CEA检测鉴别良恶性胸水价值探讨

目的　为寻找简便有效的方法对良恶性胸水进行鉴别诊断。方法　采用放射免疫分析技术对健康对照组３０ 例、已确诊的恶性胸水组１５ 例、良性胸水组３３ 例血清及胸水进行ＣＡ－５０、ＣＥＡ平行对照检测。结果　恶性胸水组血清及胸水ＣＡ－ ５０、ＣＥＡ水平显著高于良性胸水组。结论　提示对胸水进行ＣＡ－ ５０ 、ＣＥＡ检测有利于良恶性胸水鉴别诊断,且ＣＡ－ ５０ 与ＣＥＡ联合检测可提高恶性胸水诊断阳性率。     

Evaluation of cytokeratin 19 fragment (CYFRA 21-1) as a tumor marker in malignant pleural effusion

BACKGROUND: The aim was to investigate the diagnostic utility of CYFRA 21-1 (cytokeratin 19 fragment) as a tumor marker in pleural effusion and evaluate the value of combining CYFRA 21-1 and carcinoembryonic antigen (CEA) assays as a diagnostic aid in the malignant pleural effusion. METHODS: One hundred and twenty-six patients (72 malignant and 54 benign pleural effusion) were included in this retrospective study. The effusion levels of CYFRA 21-1 and CEA were measured using radioimmunometric assay. RESULTS: The median values of CYFRA 21-1 in benign and malignant pleural effusion are 15 and 70 ng/ml, respectively. Using a cut-off value of 50 ng/ml, defined at 94% specificity, the diagnostic sensitivity of CYFRA 21-1 for non-small cell lung carcinoma (n = 61), squamous cell carcinoma (n = 21), adenocarcinoma (n = 40) and small cell lung cancer (n = 11) was 64, 71, 60 and 18%, respectively. Regardless of cell types, the diagnostic sensitivity of CYFRA 21-1 and CEA in malignant pleural effusion (n = 72) was 57 and 60%, respectively (cut-off value of 10 ng/ml in CEA assay). Combining CEA with CYFRA 21-1, the diagnostic sensitivity may increase up to 72%, which was defined at 89% specificity. CONCLUSION: CYFRA 21-1 assay may be a useful tumor marker for discriminating benign from malignant pleural effusion, especially in those of non-small cell lung cancer. The combined use of CEA and CYFRA 21-1 assay in the malignant effusion may increase the diagnostic yield compared with CEA or CYFRA 21-1 alone.     

Clinical utility of pleural fluid YKL-40 as a marker of malignant pleural effusion

Pleural effusion is a common presenting feature of malignancy. Malignant pleural effusion is primarily diagnosed by pleural fluid cytology, pleural biopsy, and tumor markers. The glycoprotein YKL-40 is a new tumor marker that has shown to have a good diagnostic accuracy to detect malignant pleural effusion. However, there are only a few studies that have evaluated pleural fluid YKL-40 for detecting malignant pleural effusions. Hence, we conducted this study to evaluate the utility of pleural fluid YKL-40 to detect malignant pleural effusion. This is a cross-sectional study conducted between February 2016 and December 2017 in a tertiary care referral hospital. One hundred and forty-seven consecutive patients with pleural effusion were included in the study. These patients were divided into 3 groups, viz malignant, tuberculous, and parapneumonic pleural effusion, based on clinical features, radiological examination, and pleural fluid analysis. Pleural fluid YKL-40 levels were measured using enzyme-linked immunosorbent assay. Out of the 147 consecutive patients included in the study, 47 patients (31.97%) had malignant pleural effusion, 51 patients (34.69%) had tuberculous pleural effusion, and 49 patients (33.33%) had parapneumonic pleural effusion. The median pleural fluid YKL-40 level was higher in malignant pleural effusion (114.80 ng/mL) compared to tuberculous (93.17 ng/mL) and parapneumonic pleural effusion (89.87 ng/mL; P < 0.05). A diagnostic cut-off for pleural fluid YKL-40 value of 99.76 ng/mL detected malignant pleural effusion with 83% sensitivity, 87% specificity, positive predictive value (PPV) of 75%, negative predictive value (NPV) of 91.58%, and diagnostic accuracy of 85.71%. The level of pleural fluid YKL-40 is significantly elevated in malignant pleural effusion. In lymphocytic pleural effusions presenting with low adenosine deaminase levels and high YKL-40 levels, a thorough diagnostic search for malignancy is warranted.     

六种肿瘤标志物在肺癌胸腔积液中的诊断价值

目的通过对胸腔积液和血清中6种肿瘤标志物的检测及胸腔积液脱落细胞学检查,探讨各指标在肺癌胸腔积液中的诊断价值。方法应用化学发光法和酶联免疫分析法测定50例肺癌和30例肺良性疾病患者的胸腔积液和血清中的癌胚抗原（CEA）、糖类抗原19—9（CA19—9）、鳞状细胞癌抗原（SCC）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21—1）、胃泌素前体释放肽（ProGRP）水平,同时对胸腔积液标本进行脱落细胞学检查,并根据受试者工作特性曲线（ROC）建立合理的临床判断临界值。结果肺癌患者胸腔积液中6种肿瘤标志物水平均高于肺良性疾病者,其中CEA、CA19-9、CYFRA21—1、ProGRP水平显著高于肺良性疾病组（P〈0．05）。胸腔积液CEA、血清CYFRA21—1及CEA含量在胸腔积液与血清中的比值（P／S）在各组中的ROC曲线下面积最大。结论胸腔积液CEA、血清CYFRA21—1及CEA的P／S值在鉴别良、恶性胸腔积液中有一定的辅助诊断价值,胸腔积液CEA的诊断价值最大。     

Elevation of sialyl stage-specific mouse embryonic antigen levels in pleural effusion in patients with adenocarcinoma of the lung

Sialyl stage-specific mouse embryonic antigen (SSEA-1) levels were measured in pleural effusions obtained from patients with lung cancer and benign pulmonary disease, using a solid-phase immunoradiometric sandwich assay. The mean (+/- SEM) levels (unit/ml) of pleural fluid sialyl SSEA-1 were 3620 +/- 1419 in adenocarcinoma (n = 25), 123 +/- 30 in nonadenocarcinoma (n = 13) and 95 +/- 19 in benign pulmonary disease (n = 13), respectively. The positive rate was 64% in adenocarcinoma, 7.7% in nonadenocarcinoma, and 0% in benign pulmonary disease, respectively, when a cutoff level was defined as the mean + 3 SD value (300 unit/ml) based on pleural fluid sialyl SSEA-1 levels in benign pulmonary disease. There was a significant positive correlation between pleural fluid levels of sialyl SSEA-1 and those of carcinoembryonic antigen in adenocarcinoma patients (r = 0.8246, P less than 0.01). Pleural fluid sialyl SSEA-1 levels correlated with cytologic findings in adenocarcinoma patients. These observations suggest that sialyl SSEA-1 in pleural effusion is a useful marker to discriminate malignant from nonmalignant and adenocarcinoma from nonadenocarcinoma of the lung.     

Differential diagnosis of pleural effusions

Pleural effusion is an important and common clinical finding. Pleural effusions can be readily obtained for analysis, and the examination of the cells therein is considered to be one of the most important diagnostic tools available for differentiating between malignant and non-malignant effusions. The present study was undertaken to test the diagnostic value of the determination of CEA in pleural fluid for a variety of diseases. Sixteen patients with pleural effusions were studied. Seven patients had carcinoma of the cervix, 7 of the ovary and 2 of the corpus. The positive rate of malignant cells was 81%. Among malignant effusions, only 44% of patients showed a CEA value above 10 mg/ml. This investigation suggests that cytological examination of pleural fluid is of considerable clinical significance for diagnosing the nature of pleural effusions, and effusion fluid CEA assay may provide a useful adjunct in the evaluation of effusion fluids for malignancy.     

The use of CA-50 radioimmunoassay inhibition test in the differential diagnosis of benign and malignant breast disease

The role of the tumour marker CA-50 has been studied in the differential diagnosis of benign and malignant breast disease. Serum levels of CA-50 were determined by radioimmunoassay using a level of 17 units/ml as a cut-off. All 50 normal subjects and 22 of 24 patients (92%) with benign breast disease had CA-50 levels below 17 units/ml. By contrast, 15 of 36 patients (42%) with breast carcinoma had serum CA-50 levels above 17 units/ml (P less than 0.001). There was no clear correlation with tumour stage. The data suggest that CA-50 levels may help to differentiate benign and malignant diseases of the breast.     

联合检测EGFR、CEA对恶性胸腔积液的诊断价值

目的:评价联合检测胸腔积液患者的胸水细胞块表皮生长因子受体（epidermal growth factor receptor,EGFR）基因拷贝数,以及胸水、血清CEA水平对良恶性胸腔积液鉴别诊断的价值。方法:应用荧光原位杂交技术（Fish法）检测恶性胸腔积液（n=35）、良性胸腔积液（n=30)组患者胸水细胞块EGFR基因拷贝数水平。采用电化学发光全自动生化分析仪检测胸水及血清中CEA水平,根据受试者工作特性曲线（ROC）选取最佳灵敏性和特异性的点作为临界值,评价CEA及联合检测EGFR基因拷贝数对良恶性胸腔积液的诊断价值。结果:35例恶性胸腔积液完成Fish检测。恶性胸腔积液中15例阴性,20例阳性,阳性率为57.1％。其中13例为EGFR基因高度多体性,7例为EGFR基因扩增。肺腺癌16例中,EGFR基因高度多体性、扩增14例,肺腺癌扩增率为87.5％;肺鳞癌14例中,EGFR基因簇状扩增3例(21.4％),点状扩增3例(21.4％),无扩增8例(57.1％),肺鳞癌扩增率为42.9％。腺癌Fish阳性率(87.5％)高于鳞癌(42.9％）,P<0．01。30例良性胸腔积液中有1例脓胸患者EGFR Fish检测阳性,阳性率为3.3%,余检测结果均阴性。恶性胸腔积液患者胸水及血清CEA分别为（220.9±71.65）ng/ml、(18.11±11.38）ng/ml,显著高于良性胸腔积液组（2.31±1.29)ng/ml、(1.67±1.06）ng/ml,差异有统计学意义（P<0.01）。其中,恶性胸腔积液胸水CEA明显高于血清CEA,而良性胸腔积液组中,胸水CEA与血清CEA无明显差异。肺腺癌所致胸水及血清CEA分别为（441.02±102.65)ng/ml、(32.87±28.66）ng/ml,鳞癌所致胸水及血清CEA分别为（28.75±21.39）ng/ml、（5.99±5.32）ng/ml,腺癌显著高于鳞癌,差异有统计学意义（P<0.01）。比较胸水EGFR、CEA对良恶性胸腔积液诊断的效能,两者之间无明显差异（P=0.453＞0.05）。Spearman相关性分析胸水EGFR同CEA之间存在显著正相关。结论:EGFR在恶性胸腔积液的形成中起重要作用,通过Fish技术检测胸水细胞块EGFR基因拷贝数可行,其敏感性为57.1%。对肺腺癌导致恶性胸腔积液的诊断敏感性为87.5%。CEA（临界值5.0ng/ml）在恶性胸腔积液及血清中显著高于良性,其中胸水CEA检测诊断敏感性为65.7%,而在腺癌中为87.5%,其在胸水及血清中的比值＞1.5有助于恶性胸腔积液的诊断。EGFR基因突变阳性与肿瘤标记物CEA阳性表达呈正相关,尤见于肺腺癌患者,两者联合检测可提高诊断性试验的准确性。     

Diagnostic value of CEA, CA 15-3, CA 19-9, CYFRA 21-1, NSE and TSA assay in pleural effusions

The aim of this study was to evaluate the individual and combined diagnostic utility of six tumor markers in patients with pleural effusion. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA 15-3), carbohydrate antigen 19-9 (CA 19-9), cytokeratin fragment 19 (CYFRA 21-1), neuron-specific enolase (NSE) and total sialic acid (TSA) were assayed in 74 patients with pleural effusions (44 malignant and 30 benign). All tumor markers except TSA and NSE were increased in both serum and pleural fluid of patients with malignant diseases. Using the cut-off values 3 ng/ml, 14 U/ml, 5 U/ml, 8 ng/ml and 70 mg/dl for pleural fluid CEA, CA 15-3, CA 19-9, CYFRA 21-1 and TSA, respectively, the sensitivity (%) and specificity (%) of these tumor markers were as follows: CEA; 52/77, CA 15-3; 80/93, CA 19-9; 36/83, CYFRA 21-1; 91/90, TSA; 80/67, for differentiating malignant effusions from benign. When CA 15-3 and CYFRA 21-1 combined, the sensitivity and specificity were increased (100 and 83%, respectively). Classifying the malignant effusions as bronchial carcinoma and malignant pleural mesothelioma, CEA was shown to have the highest sensitivity and specificity (88 and 90%, respectively) while the combination of CEA with other tumor markers increased sensitivity but decreased specificity. According to our results, tumor markers are not suitable for the differential diagnosis of malignancy.     

Potential diagnostic value of methylation profile in pleural fluid and serum from cancer patients with pleural effusion

BACKGROUND: The objective of this study was to investigate the diagnostic value of methylation profiles for discrimination between malignant and benign pleural effusions. A secondary objective was to examine the concordance of methylation in samples of serum and pleural fluid. METHODS: The authors used methylation-specific polymerase chain reaction (MSP) analysis to examine the promoter methylation status of 4 genes in patients with pleural effusion: death-associated protein kinase (DAPK), Ras association domain family 1A (RASSF1A), retinoic acid receptor beta (RARbeta), and p16/INK4a. Pleural effusions were collected from 87 patients who had their diagnoses confirmed on cytologic and/or histologic examinations and clinical evolution. Pleural effusions were classified as malignant (n = 53 patients) or benign (n = 34 patients). RESULTS: Methylation was detected in serum from 45.3% of patients with malignant pleural effusions and from 0% of patients with benign pleural effusions, and it was detected in pleural fluid samples from 58.5% of patients with malignant pleural effusions and from 0% of patients with benign pleural effusions (P = .001). The sensitivity of MSP was greater than that of cytologic examination alone (39.1%; P = .001). When MSP was used together with cytologic examination, sensitivity increased to 69.8% (P = .001). CONCLUSIONS: Cell-free methylated DNA in pleural fluid can be detected in patients with neoplastic malignancy in a single extraction by thoracocentesis. Adequate management of the extracted pleural fluid can provide a rapid and reliable diagnosis in patients with pleural effusions who have suspected malignancy. MSP, used together with cytologic examination, may obviate the need for other invasive diagnostic tests.     

胸腔积液与血清癌胚抗原比值对胸腔积液性质的诊断效果

目的探讨胸腔积液与血清癌胚抗原比值对胸腔积液性质的诊断效果。方法选取2018年1月至2019年10月间上海市宝山区罗店医院收治的86例胸腔积液患者,按照胸腔积液良恶性质将患者分为恶性组34例和良性组52例。使用电化学发光免疫分析法检测患者的胸腔积液、血清癌胚抗原水平,计算两者比值,比较两组患者及恶性组不同病理类型的上述指标水平的高低以及阳性率差异。结果恶性组患者胸腔积液癌胚抗原水平为(28.26±5.92)ng/ml,血清癌胚抗原水平为(14.29±3.61)ng/ml,比值为(2.16±0.74),良性组患者胸腔积液癌胚抗原水平为(1.03±0.44)ng/ml,血清癌胚抗原水平为(2.21±0.67)ng/ml,比值为(0.53±0.21),恶性组上述指标均高于良性组,差异均有统计学意义(均P<0.05)。恶性组患者胸腔积液癌胚抗原阳性率为91.2%,血清癌胚抗原阳性率为85.3%,胸腔积液与血清癌胚抗原比值阳性率为91.2%,良性组的胸腔积液癌胚抗原阳性率为7.7%,血清癌胚抗原阳性率为11.5%,胸腔积液与血清癌胚抗原比值阳性率为1.9%,恶性组上述指标均高于良性组,差异均有统计学意义(均P<0.05)。结论联合检测胸腔积液和血清癌胚抗原水平及两者比值,有助于鉴别胸腔积液良恶性,且敏感性高,具有重要的临床价值。