良、恶性胸水表达癌胚抗原信使核糖核酸--癌胚抗原系统差别的研究

目的分析癌胚抗原信使核糖核酸(CEAmRNA)-癌胚抗原(CEA)系统在良、恶性胸水中表达的差别,探讨应用CEAmRNA和CEA指标诊断恶性胸水的价值.方法采集胸水为检测标本,其中恶性胸水92例、良性胸水54例.应用反转录-套式-聚合酶链反应(RT-NP-PCR)检测CEAmRNA,应用磁性抗体分离酶联免疫测定(MAIA)检测CEA.结果不同胸水表达CEAmRNA和CEA的阳性结果分别为良性5.6%(3/54)和7.4%(4/54)、恶性80.4%(74/92)和54.3%(50/92),两者差别具有统计学意义(P＜0.001).指标诊断恶性胸水的特异性和敏感性分别为CEAmRNA 94.4%和80.4%,CEA分别为92.6%和54.3%,CEAmRNA的敏感性明显高于CEA(P＜0.01).结论CEAmRNA-CEA系统在良、恶性胸水中的表达的差别具有统计学意义,可以用作诊断与鉴别诊断恶性胸水的指标.其中,CEAmRNA在恶性胸水中的表达率和敏感性比CEA更高,有望成为一个新的、有实用价值的肿瘤标志物.

Study on different expression of carcinoembryonic antigen messenger ribonucleic acid-carcinoembryonic antigen in benign or malignant pleural effusion

Objective To analyse the different expression of carcinoembryonic antigen messenger ribonucleic acid (CEAmRNA) and carcinoembryonic antigen (CEA) in benign or malignant pleural effusion for the diagnostic value of CEAmRNA and CEA in malignant pleural effusion.Methods The objects of study consisted of 92 patients with malignant pleural effusion and 54 patients with benign pleural effusion.The detected specimens were the pleural effusion from the patients.CEAmRNA was detected by reverse transcriptase-nested primers-polymerase chain reaction (RT-NP-PCR) and CEA was detected by magnetic antibody immunoenzymetric assay (MAIA).Results The positive results of expression were different: CEAmRNA and CEA were 5.6% (3/54) and 7.4% (4/54) in the benign group; CEAmRNA and CEA were 80.4% (74/92) and 54.3% (50/92) in malignant group.The differences on the positive results of CEAmRNA and CEA had statistic significance between benign and malignant pleural effusion (P< 0.001).The specificities of CEAmRNA and CEA in diagnosing the malignant pleural effusion were 94.5% and 92.6%; the sensitivities were 80.4% and 54.3% respectively.The sensitivity of CEAmRNA was higher than that of CEA (P< 0.01).Conclusion The positive expressions of CEAmRNA and CEA have significant difference between benign and malignant pleural effusion.CEAmRNA and CEA are useful index for diagnosis and differential diagnosis of malignant pleural effusion.The rate of positive expression and sensitivity of CEAmRNA are higher than CEA in malignant pleural effusion, and CEAmRNA expects to be a useful and new marker of carcinoma.