CEA、CYFRA21-1、TSGF对恶性胸水诊断价值的研究

目的通过对胸水中CEA（癌胚抗原）、CYFRA21-1（细胞角蛋白19片段）、TSGF（恶性肿瘤特异性生长因子）的检测，探讨此三项指标在恶性胸水诊断中的价值。方法应用酶联免疫法（ELISA）对59例恶性胸水和48例良性胸水进行检测。结果恶性胸水组中CEA、CYFRA21-1、TSGF在胸水中的含量明显高于良性胸水组（P〈0．01）。CYFRA21-1在肺鳞癌中表达水平最高，CEA在肺腺癌中表达水平最高。其敏感性和特异性分别为：CEA：81．36％，91．67％；CYFRA21-1：91．53％，79．17％；TSGF：86．44％，89．58％。胸水CEA＋CYFRA21-1＋TSGF联合检测肺癌的的敏感性为93．22％，特异性为60．42％，阳性预测值为84．69％，阴性预测值为86．58％。结论CEA、CYFRA21-1、TSGF的联合检测在恶性胸水的诊断中有重要的I临床应用价值。

Study on diagnostic value of CEA、CYFRA21-1 and TSGF in malignant pleural effusion

Objective To evaluate the diagnostic value of CEA、CYFRA21-1 and TSGF in maligant pleural effusions. Methods Pleural effusions CEA、CYFRA21-1 and TSGF were determined by bnzyme linked immunosorbent essay （ELISA） in 59 patients with malignant pleural effusions and 48 patients with benign pleural effusions. Results The levels of CEA、CYFRA21-1 and TSGF in effusion of patients with maligant pleural effusions were significantly higher than these with benign lung dieasses （ P 〈0. 01 ）. The sensitivity and specificity of CEA for malignant pleural effusions were 81.36% ,91.67%. The sensitivity and specificity of CYFRA21-1 for malignant pleural effusions were 91.53% ,79. 17%. The sensitivity and specificity of TSGF for malignant pleural effusions were 86.44% ,89.58%. The sensitivity,spocificity,positive predictive value and negative predictive value of CEA ＋ CYFRA21-1 ＋ TSGF were 93.22% 、60. 42%、 84. 69% and 86. 58%. Conclusions Combined CEA 、CYFRA21-1 and TSGF measurement might be an useful index in diagnoisis of malignant pleural effusions.