神经元特异性烯醇化酶、细胞角质蛋白19片断、癌胚抗原联合LDH、ADA检测对良、恶性胸腔积液鉴别的意义

目的探讨血清、胸水中神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片断（CYFRA21—1）、癌胚抗原（CEA）对良、恶性胸腔积液的鉴别价值。方法对40例经病理确诊的胸腔积液患者按胸水的性质分为恶性胸水组（23例）和良性胸水组（17例）。2组患者均采用电化学发光法检测血清及胸腔积液中NSE、CYFRA21—1、CEA的含量．生化检测胸腔积液中乳酸脱氢酶（LDH）和腺苷脱氨酶（ADA）。结果恶性胸水组的血清NSE、CYFRA21—1及CEA均显著高于良性胸水组（P=O,02、0．02及0．01）；胸水CYFRA21—1及CEA均明显高于良性胸水组（严如．01或P=0．04），ADA显著低于良性胸水组（P=0．01）。2组胸水NSE、LDH比较差异无统计学意义（均P〉O．05）。结论血清、胸腔积液中NSE、CYFRA21—1、CEA和ADA联合检测，对良、恶性胸腔积液的鉴别诊断有重要价值，能提高准确率。

Significances of Levels of Neuron-specific Enolase,Cytokeratin 19 Fragment,Carcinoembryonic Antigen,Lactate Dehydrogenase and Adenosine Deaminase in Differentiation of Malignant and Benign Pleural Effusions

Objective To investigate the values of neuron-specific enolase （NSE）,cytokeratin 19 fragment （CYFRA21-1） and carcinoembryonic antigen （CEA） levels in ~enim and pleural fluid in the differentiation of malignant and benign pleural effusions. Methods Forty patients with pathologically confirmed pleural effusions were divided into malignant pleural effusion group （n=23）and benign pleural effusion group （n=lT）.The levels of NSE,CYFRA21-1 and CEA in serum and pleural fluid were detected by electrochemiluminescence assay. The levels of lactate dehydrogenase （LDH）and adenosine deaminase （ADA） in pleural fluid were detected by biochemical assay. Results Serum NSE, CYFRA21-1 and CEA levels in malignant pleural effusion group were significantly higher than those in benign pleural effusion group （P=0.02,P=0.02 and P=0.01, respectively）. Pleural fluid CYFRA21-1 and CEA levels in malignant pleural effusion group were also significantly higher than those in benign pleural effusion group（P=0.01 and P=0.04, respectively）.However, pleural fluid ADA levels in malignant pleural effusion group were significantly lower than those in benign pleural effusion group （P=0.01）. There were no statistical differences in pleural fluid LDH and NSE levels between the two groups （P〉 0.05）. Conclusion The combined detection of NSE,CYFRA21-1 ,CEA and ADA levels in serum and pleural fluid is a valuable method and can improve the accuracy in differential diagnosis of malignant and benign pleural effusions.