3项联合检测在诊断结核性和恶性胸腔积液中的价值

目的测定胸腔积液和血清中腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)与癌胚抗原(CEA)的水平,探讨其指标联合检测对结核性和恶性胸腔积液的鉴别诊断意义。方法收集临床已确诊的86例胸腔积液患者(结核性48例,恶性38例)的胸腔积液和血清分别采用酶免疫法和化学发光法进行ADA、LDH和CEA含量测定。结果结核性胸腔积液ADA含量较恶性胸腔积液组明显增高(P0.01),CEA在恶性胸腔积液中含量较结核性胸腔积液组明显增高(P0.01)。3项指标联合检测敏感性为78.3%,特异性为93.7%,较单一指标的特异性高。结论联合检测ADA、LDH和CEA对不明原因的胸腔积液,在诊断和鉴别诊断上具有重要意义,能提高诊断准确率。

Diagnostic value of combined determination of serum ADA,LDH and CEA in tuberculous and malignant pleural effusion

Objective To determine the differential diagnostic value of combined determination of serum adenosine deaminase（ADA）,lactate dehydrogenase（LDH）and carcinoembryonic antigen（CEA）in tuberculous and malignant pleural effusion.Methods There were 86 cases including 38 patients with malignant pleural effusion（malignant group）and 48 patients with tuberculous pleural effusion（tuberculous group）in this study.ADA and LDH were detected by terminal reaction of enzymology,and CEA was detected by chemiluninescence immunoassay.Results The concentrations of ADA in tuberculous pleural effusion were significantly higher than those in malignantpleural effusion（P〈0.01）.However,the concentrations of CEA（pleural effusion/serum）in malignant pleural effusion were significantly higher than those in tuberculous pleural effusion（P〈0.01）.The sensitivity and specificity of combined determination of three indexes were 78.3% and 93.7% respectively.And the specificity was higher in these indexes significantly compared with the single test.Conclusion The combined determination of ADA,LDH and CEA in pleural effusion is of great value in differentiating tuberculous pleural effusion from malignant pleural effusion.