肿瘤标记物联合检测在诊断良恶性胸腔积液中的意义

目的研究肿瘤标记物癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和细胞角蛋白片段抗原21—1（CYFRA21—1）单独或联合检测对恶性胸腔积液的诊断意义。方法回顾性分析26例良性和24例恶性胸腔积液患者的胸腔积液和血清的CEA、NSE和CYFRA21—1检测资料。结果恶性胸腔积液患者的胸腔积液和血清中CEA、NSE和CYFRA21—1的含量以及3项标记物的胸腔积液／血清比值均高于良性患者（P〈0．05）；在恶性患者的胸腔积液的单项检测中，CYFRA21—1的敏感度（79．1％）和特异度（80．8％）最高；采用3项（CEA＋NSE＋CYFRA21-1）指标联合检测，其阳性数、敏感度、特异度、准确性方面均高于单项检测。结论肿瘤标记物联合检测在鉴别良、恶性胸腔积液中具有重要意义。

Clinical significance of combined detection of tumor markers in differential diagnosis of benign and malignant pleural effusions

Objective To investigate the clinical significance of individual or combined detection of such tumor markers as carcinoembryonie antigen （CEA） , neuron - specific enolase （NSE） and cytokeratin fragment antigen 21 - 1 （ CYFRA21 - 1 ） in benign and malignant pleural effusions. Methods The clinical data of the levels of CEA, NSE and CYFRA21 - 1 in serum and pleural effusion of 26 hospitalized patients with benign pleural effusions and 24 patients with malignant pleural effusions were analyzed retrospectively. Results The levels of CEA, NSE and CYFRA21 - 1 in serum and pleural effusions in patients with malignant pleural effusions and the ratio of their levels in pleural effusion and serum were significantly higher compared with the benign group （P 〈 0.05）. Among the individual detections of tumor markers in the malignant group, the sensitivity （79.1% ） and specificity （80.8%） of CYFRA21 - 1 were highest. The positive number, sensitivity, specificity and accuracy in combined detection of CEA, NSE and CYFRA21 - 1 were higher than those in individual detections of tumor markers. Conclusion The combined detection of tumor markers plays important roles in the differential diagnosis of benign and malignant pleural effusions.