细胞学与细胞角蛋白19片段检测在胸水诊断中的作用

目的探讨细胞学与细胞角蛋白19片断(CYFRA21-1)联检对恶性胸水的临床诊断价值。方法采用电化学发光免疫分析技术,检测良性胸水组58例、恶性胸水组125例胸水中的CYFRA21-1表达水平,并同时作细胞学检查。结果恶性胸水组细胞学与CYFRA21-1敏感性分别为74.4%和80.8%,而特异性分别为96.6%和89.7%。细胞学和CYFRA21-1两项联合检测可使敏感性提高到90.4%,与单检比较有统计学意义(P<0.05);但特异性降低为86.2%,与单检比较无统计学意义(P>0.05)。结论细胞学可作为恶性胸水确诊的依据,CYFRA21-1为辅助诊断恶性胸水较好的肿瘤标志物,两者联合检测可提高检出率。

Application of detection of cytology and CYFRA - 21 in diagnosis of hydrothorax

Objective To study the application of cytology and Cytokeraetin 19 fragment (CYFRA21-1) in the diagnosis of malignancy hydrothorax. Methods Serum levels of CYFRA21-1 in 125 patients with malignancy hydrothorax and 58 patients with benign hydrothorax were measured by elctrochemiluminescence immuno- assay (ECLIA), and cytology examination was carried in the same time. Results The sensitivities of cytology examination and CYFRA21-1 in malignancy hydrothorax groups were 74.4% and 80.8%, respectively. And their specificities were 96.6% and 89.7%. The sensitivity of combined two examinations increased to 90.4%, there was signifcant difference compared to single tumor marker detection (P>0.05) and the specificity was 86.2%, there was no significant difference compared to single tumor marker detection (P>0.05). Conclusion Cytology examination may serve as a gist to diagnose malignancy hydrothorax. CYFRA21-1 may be a serum tumor marker to assist diagnosis of malignancy hydrothorax. Combination of two kinds of examination can increase the detective positive rate.