胸腔积液引流沉淀物在恶性胸腔积液中的诊断价值

目的评价胸腔积液引流沉淀物在恶性胸腔积液中的诊断价值。方法对36例恶性胸腔积液用中心静脉导管（ARROW管）行胸腔闭式引流,引流袋中的沉淀物行组织病理学检查,同时,胸腔积液行脱落细胞学检查作为对照。结果胸腔积液引流沉淀物组织病理学检查肿瘤阳性率明显高于胸腔积液脱落细胞学检查（P〈0.05）。结论胸腔积液引流沉淀物组织病理学检查肿瘤阳性率高,值得临床推广应用。     

VEGF及Angiopoietin-2对恶性胸腔积液的诊断价值

目的：探讨检测血管内皮生长因子（vascular endothelial growth factor,VEGF）及血管生成素-2（An—giopoietin-2,Ang-2）对恶性胸腔积液的诊断价值。方法：选择恶性胸腔积液患者31例,良性胸腔积液3例,（Roc）曲线计算上述指标的诊断敏感度、特异度及ROC曲线下面积。并对VEGF及Ang-2之间的相关性进行分析。结果：恶I生胸腔积液中的VEGF及Ang-2含量（1106±555vs527±229,19．26±6．39VS12．25±7．1）明显高于良性胸腔积液（P〈0．05）;VEGF诊断恶性胸腔积液的敏感度及特异度分别是：82％和90％,Ang-2诊断的敏感度及特异度分别是：65％和71％;恶性胸腔积液中Ang-2的含量与VEGF的含量呈正相关。结论：VEGF及Ang-2可作为恶性胸腔积液诊断的良好指标,可指导选择对患者进行进-步的侵入性检查。     

VEGF与TGF-β1在胸腔积液鉴别诊断中的价值

目的:探讨癌性胸水和结核性胸水患者血清及胸水中转化生长因子β1（TGF-β1）和血管内皮生长因子（VEGF）的表达及其临床意义。方法:用双抗体夹心酶联免疫吸附法（ELISA）检测58例癌性胸水患者及46例结核性胸水患者血清及胸水中的TGF-β1和VEGF的水平,比较两组血清和胸水中TGF-β1和VEGF表达水平的差异以及与临床的关系。结果:58例癌性患者血清和胸水中TGF-β1和VEGF的含量分别为:（30.5±11.8）ng/ml、（41.8±7.5）ng/ml,（580±143.8）pg/ml、（640±158.4）pg/ml;46例结核组患者血清和胸水中TGF-β1和VEGF的含量分别为:（11.9±9.9）ng/ml、（17.6±5.8）ng/ml,（121.5±22.3）pg/ml、（135.4±23.5）pg/ml;二者相比具有显著性差异（P<0.01）。TGF-β1表达水平与VEGF水平呈正相关。结论:监测胸水中TGF-β1和VEGF的含量对鉴别良恶性胸水有一定的临床意义。     

VEGF 与 EGFR 在胸腔积液鉴别中的意义

近年来发现VEGF及EGFR在不同疾病致胸腔积液的形成过程中发挥了重要作用,本文旨在探讨以血管内皮生长因子（VEGF）及表皮生长因子受体（EGFR）为指标判断胸液良恶性的作用。     

VEGF、VEGFR-1和MMP-9对良恶性胸腔积液的诊断价值

目的 探讨血管肉皮生长因子(VEGF)、受体VEGFR-1和基质金属蛋白酶-9(MMP-9)表达在良、恶性胸腔积液鉴别诊断中的价值.方法 采用ELISA法,检测35例恶性胸腔积液、33例良性胸腔积液患者胸腔积液中VEGF,VEGFR-1和MMP-9表达水平,并进行相关性比较分析.结果 恶性胸腔积液组中VEGF、VEGFR-1表达均明显高于良性胸腔积液,MMP-9表达明显低于良性胸腔积液,差异均有统计学意义(P＜0.05).恶性胸腔积液中VEGF,VEGFR-1和MMP-9表达水平呈正相关.VEGF,VEGFR-1和MMP-9与恶性胸腔积液的病理类型无相关性.结论 胸腔积液中VEGF,VEGFR-1和MMP-9表达可以作为良性和恶性胸腔积液鉴别诊断的标志物.     

血管内皮生长因子测定对鉴别结核性和恶性胸腔积液的意义

目的　探讨血管内皮生长因子 (VEGF)测定对鉴别结核性和恶性胸腔积液的意义。方法　采用酶联免疫吸附试验(ELISA)法检测 2 6例恶性胸腔积液患者和 18例结核性胸腔积液患者血清和胸腔积液中VEGF含量。结果　恶性胸腔积液患者血清和胸腔积液中VEGF含量分别为 ( 787.3± 82 .9) pg/ml ,( 3390 .9± 468.5 ) pg/ml ,明显高于结核性胸腔积液患者 [分别为( 32 4.1± 84.2 ) pg/ml ,( 10 5 8.1± 137.8)pg/ml] ,P <0 .0 1。 2组患者的血清和胸腔积液的VEGF比值自相比较也存在显著性差异 (P <0 .0 5 )。联合检测血清和胸腔积液中的VEGF对恶性胸腔积液诊断的特异性为 94.4% ,敏感性为 65 .4%。结论　血清和胸腔积液中VEGF的测定有利于结核性和恶性胸腔积液的鉴别诊断     

端粒酶检测在良恶性胸腔积液鉴别诊断中的应用价值

端粒酶是一种能以自带RNA为模板，反转录合成端粒DNA加于染色体末端的核糖核酸蛋白酶，作用是维持染色体稳定，使细胞具有永生化特性。胸腔积液可由多种疾病引起，与肿瘤因素有关者占30％～60％。作为目前最具特异性和普遍性的恶性肿瘤标志物，检测胸腔积液中端粒酶的活性，对早期发现肿瘤，具有重要意义。     

PET/CT鉴别肺癌中胸腔积液性质的临床价值

背景与目的 胸腔积液是肺癌患者常见的临床表现,鉴别胸水的性质有重要意义.正电子发射断层扫描/计算机体层摄影(positron emission tomography/computed tomography,PET/CT)是鉴别肺部良恶性肿瘤和纵隔淋巴结分期的重要诊断方法之一.本研究旨在探讨PET/CT鉴别肺癌中胸腔积液性质的临床价值.方法 回顾性分析合并胸腔积液的病理确诊的肺癌病例,以病理或临床随访为最后诊断标准,计算PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阴性预测值、阳性预测值和准确率.结果 33例肺癌患者符合条件纳入分析PET/CT诊断肺癌恶性胸腔积液的敏感性、特异性、阳性预测值、阴性预测值和准确率分别为81.5％、83.3％、95.7％、50.0％和81.8％.结论 PET/CT对鉴别肺癌中胸腔积液的性质具有重要作用,假阳性率低,对PET/CT阴性的胸腔积液,需有创检查确认.     

血管内皮生长因子和癌胚抗原测定对良、恶性胸腔积液诊断价值的对比研究

目的 研究胸腔积液血管内皮生长因子（VEGF）对良，恶性胸腔积液鉴别诊断的价值。并与癌胚抗原（CEA）进行对比。方法 采用双抗体夹心法检测胸腔积液VEGF和CEA的水平。根据最终诊断结果。30名患者分为两组：（1）良性胸腔积液组16例；（2）恶性胸腔积液组14例，并将VEGF检测结果与CEA水平进行对比。结果 恶性胸腔积液组有13例患者的VEGF呈高活性（D值118-482pg/L)。结论 胸腔积液VEGF的检测对鉴别良，恶性胸腔积液明显优于CEA的测定，可作为一种诊断恶性胸腔积液的有力手段。     

胸腔积液中肿瘤坏死因子、癌胚抗原和神经元特异性烯醇化酶的检测及诊断价值研究

目的探讨检测胸水中肿瘤坏死因子（TNF-α）、癌胚抗原（CEA）和神经元特异性烯醇化酶（NSE）对胸腔积液的诊断价值。方法采用电化学发光酶免疫分析法检测59例结核性胸水和48例肺癌性胸水患者胸水中TNF-α、CEA和NSE水平。结果结核性胸水中TNF-α水平显著高于肺癌性胸水（P〈0.05）。肺癌性胸水中CEA和NSE明显高于结核性胸水（P〈0.01）。肺腺癌胸水中CEA升高最明显,非小细胞肺癌胸水中NSE升高最显著。联合检测CEA及NSE,诊断敏感度92.0%,准确度86.3%。结论检测TNF-α、CEA和NSE对结核性胸水和肺癌性胸水的诊断及鉴别诊断有较高的临床价值,联合检测胸水CEA和NSE可提高肺癌诊断敏感度。     

Diagnostic value of ferritin in malignant pleural and peritoneal effusions

The diagnostic usefulness of ferritin measurements in pleural and peritoneal effusions has been evaluated in 57 patients. Mean (+/- standard error [SE]) ferritin levels were 291 +/- 50 ng/ml in 24 patients with noninflammatory transudates (Group I), 942 +/- 253 in 15 patients with nonmalignant exudates (Group II), and 1805 +/- 257 in 18 patients with malignant exudates (Group III). The mean (+/- SE) ratio of effusion/serum ferritin in Groups I, II, and III was 0.7 +/- 0.1, 2.7 +/- 0.7, and 5.7 +/- 1.2, respectively. The specificity and predictive value of a ferritin ratio in excess of 1.5 in distinguishing transudates from all exudates and in distinguishing transudates from malignant exudates were both very high (94%) to 96%). In the lower range of values considerable overlap existed between ferritin ratios obtained in patients with benign versus malignant inflammatory exudates. However, very high ferritin levels (greater than 3000 ng/ml) and ferritin ratios (greater than 20:1) were only encountered in malignant exudates. These results indicate that the measurement of ferritin levels and ferritin ratios may be a useful aid in the diagnosis of malignant pleural and peritoneal effusions.     

肿瘤标志物联合检测在良恶性胸腔积液鉴别诊断中的价值

 目的　探讨胸腔积液4种肿瘤标志物联合检测在良恶性胸腔积液鉴别诊断中的价值。方法　采用电化学发光免疫法检测126例胸腔积液患者（其中恶性组52例,良性组74例）癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原15-3（CA15-3）和细胞角蛋白片段19（CYFRA21-1）水平, 并计算上述指标单独和与CEA联合检测在诊断中的敏感度、特异度、准确度和约登指数（YI）。结果　恶性组4种肿瘤标志物水平均明显高于良性组（P＜0.01）。单项检测各种肿瘤标志物的敏感度以CA125最高（90.4 %）,特异度以CYFRA21-1最高（79.7 %）,诊断准确度以CEA和CYFRA21-1最高（71.4 %）,YI以CEA最高（0.41）。联合检测较单项检测敏感度、准确度和YI明显提高,其中CEA、CYFRA21-1和CA15-3三项联合效果最好,敏感度为92.3 %,特异度为78.4 %,准确度为84.1 %,YI值最高为0.71。四项联合敏感度为94.2 %,特异度为75.7 %,准确度为83.3 %,YI值为0.70,与三项联合结果相比差异无统计学意义（P＞0.05）。结论　单项检测的诊断价值有限,CEA、CYFRA21-1和CA15-3三项联合效果最好、最经济,可指导患者恰当选择进一步的侵入性检查手段。     

腺苷脱氨酶与癌胚抗原在恶性胸腔积液的诊断价值

测定了３８例恶性胸腔积液及３４例结核性胸水的腺苷脱氨酶（ＡＤＡ）与癌胚抗原（ＣＥＡ）在胸水、血清中水平及胸水／血清值。结果恶性组胸水ＡＤＡ值明显低于结核组（Ｐ＜０．０００５），ＡＤＡ胸水／血清值低于结核组（Ｐ＜０．０００５）；恶性组胸水ＣＥＡ水平明显高于结核组（Ｐ＜０．０００５），ＣＥＡ胸水／血清值恶性组亦明显高于结核组（Ｐ＜０．０５）。胸水ＡＤＡ水平对诊断恶性胸腔积液的敏感性为９６．１５％，符异性９１．６７％；ＣＥＡ的敏感住７０．８３％，特异性为８７．５０％。综合分析胸水的ＡＤＡ、ＣＥＡ水平及胸水／血清值，有助于对恶性胸腔积液的诊断。     

Carcinoembryonic antigen in pleural effusions. Diagnostic value in malignant mesothelioma

The usefulness of the determination of carcinoembryonic antigen (CEA) in pleural effusion was assessed as an aid to the diagnosis of malignant mesothelioma. The concentration of CEA was determined by radioimmunoassay (RIA) in pleural fluid of 213 adult patients, of which 140 had malignant pleural disease and 73 had nonmalignant pleural disease. Pleural fluid CEA (PF CEA) was lower than 12 ng/ml in all 15 mesotheliomas. The statistical probability of a mesothelioma associated with PF CEA greater than 15 ng/ml was found to be zero. The CEA assay in pleural effusion proved to be a valuable adjunct to other diagnostic procedures in differentiating the malignant mesothelioma from metastatic serosal spread.     

Diagnostic value of tumor markers for differentiating malignant and benign pleural effusions of Iranian patients

In order to evaluate the diagnostic yield of tumor markers in differentiating malignant and benign pleural effusions, we carried out a prospective study in a group of Iranian people. Pleural and serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 15-3 (CA15-3), neuron-specific enolase (NSE) and cancer antigen 125 (CA 125) were assayed prospectively in patients with pleural effusion (40 malignant and 37 benign). The highest sensitivity was obtained with a combination of CA 15-3 in serum, and CA 15-3 and CEA in pleural fluid (80%), also with combination of CA 15-3 in serum, and CA 15-3, NSE and CEA in pleural fluid (80%). The highest specificity was obtained with combination of CA 15-3 in serum, and CA 15-3 and NSE in pleural fluid (100%), and also with combination of CA 15-3 in serum, and CA 15-3, NSE and CEA in pleural fluid (100%).     

Diagnostic value of pleural interleukin 17 and carcinoembryonic antigen in lung cancer patients with malignant pleural effusions

Interleukin 17 (IL-17) has been found to be increased in some human cancers; however, the possible implication of IL-17 in regulating antitumor responses in lung cancer patients with malignant pleural effusions (MPE) remains to be elucidated. This study aimed to investigate the diagnostic value of pleural IL-17 and carcinoembryonic antigen (CEA) in MPE and benign pleural effusions (BPE). Pleural effusion samples from 108 patients were classified on the basis of diagnosis as MPE (n?=?56) and BPE (n?=?52). The concentration of IL-17 was determined by enzyme-linked immunosorbent assay (ELISA). The CEA levels were also determined in all patients. A significant difference was observed in the levels of CEA (P?<?0.01) between MPE and BPE. The concentration of IL-17 in MPE was significantly higher compared to that in BPE (P?<?0.01). With a cutoff point of 15.7 pg/ml, IL-17 had a sensitivity of 76.8 % and a specificity of 80.8 % for differential diagnosis. The combined detection of IL-17 and CEA had a sensitivity of 96.4 % and a specificity of 92.3 % to distinguish MPE from BPE. The combined detection of IL-17 and CEA may be more valuable in the differential diagnosis between MPE and BPE.     

Interferon instillation for malignant pleural effusions

BACKGROUND: Malignant pleural effusions can be managed in various ways includinginstillation of antineoplastic agents. Instillations of alfainterferon-2b (IFN-     

Pleuroperitoneal shunt for malignant pleural effusions

The malignant pleural effusion was introduced into the abdominal cavity by the manual compression of a pleuroperitoneal shunt tube, which was indwelt in the subcutaneous tissue of the lateral chest under local anesthesia. Seven patients having malignant pleural effusion, due to lung cancer in 4 and breast cancer in 3, were used as subjects. This technique caused no serious complications. Retention of pleural effusion was markedly reduced in all of the 7 patients. Three patients, whose performance status (P.S.) was preoperatively determined to be 3 or 2, could be discharged during early periods. This technique seemed to be highly feasible in these patients, but not in those having P.S. of 4. Since peritoneal dissemination of the tumor was seen in 1 of 3 patients examined by autopsy, there is a possibility that this technique might have contributed to spread and scattering of tumor cells in the peritoneal cavity. These results suggested that this technique is useful therapeutic means for the treatment of patients in whom hospitalization is necessary due to the presence of malignant pleural effusion, while this technique involves the risk of artificial induction of peritoneal dissemination of tumor cells. Therefore, the application of this technique should be decided based on the prognosis of each patient.