联合检测胸液ANP、CEA、ADA对恶性和结核性胸腔积液的诊断价值

目的:探讨心钠素(ANP)、癌胚抗原(CEA)、腺苷脱氨酶(ADA)联合检测对恶性和结核性胸腔积液的鉴别诊断价值。方法:选择恶性胸腔积液25例、结核性胸腔积液30例,采用放射免疫直接测定法检测胸腔积液ANP含量。用酶免疫分析法(EIA)检测胸腔积液CEA水平,用比色分析法检测胸腔积液ADA含量,并对测定结果进行统计学处理。结果:ANP测定诊断恶性胸腔积液的敏感性为0.80,特异性为0.90;CEA诊断恶性胸腔积液的敏感性为0.64,特异性为0.80;ADA诊断恶性胸腔积液的敏感性为0.84,特异性为0.733;ANP与CEA、ADA联合检测诊断恶性胸腔积液的敏感性为0.96,特异性为0.967。结论:ANP测定在良恶性胸腔积液的鉴别诊斯中有重要价值,但存在假阴性和假阳性,若与CEA、ADA联合检测,对良恶性胸腔积液的鉴别诊断意义更大。

Values of Combined Pleural Effusion Testing of ANP,CEA and ADA for Differential Diagnosis of Tuberculous and Malignant Pleural Effusion

Objective: To investigate the values of combined pleural effusion testing of atrial natriuretic peptide (ANP), carcinoembryonic antigen (CEA) and adenosine deaminase (ADA) for differential diagnosis of tuberculous and malignant pleural effusion. Methods: Twenty-five cases with malignant and 30 cases with tuberculous pleural effusion were enrolled into the study. Direct radioimmunoassay was used to detect ANP of pleural effusion, and CEA levels in pleural effusion were tested by using EIA method. ADA contents in pleural effusion was tested by means of colonmetric analysis. Results: The sensitivity of ANP for diagnosing malignant pleural effusion was 0.80, and the specificity was 0.90. The sensitivity of CEA testing for diagnosing malignant pleural effusion was 0.64, and the specificity was 0.80. The sensitivity of ADA for diagnosing malignant pleural effusion was 0.84, and the specificity was 0.733. The sensitivity of the combined testing of ANP, CEA and ADA for diagnosing malignant pleural effusion was 0.96, and the combined specificity was 0.967. Conclusion: Detecting of ANP in pleural effusion has important value in differential diagnosis of benign and malignant pleural effusion, but still has false negative and false positive diagnosis. The combined testing of CEA and ADA with ANP can be more valuable in the differential diagnosis of benign from malignant pleural effusion.