CYFRA21-1、CEA联合测定对良恶性胸水的鉴别诊断价值

目的　探讨细胞角蛋白 19片段 (CYFRA2 1— 1)、癌胚抗原 (CEA)联合测定对良、恶性胸水的鉴别诊断价值。方法　应用放射免疫法 ,分别测定了 82例胸腔积液患者胸水及血清中CYFRA2 1— 1、CEA的浓度 ,并计算其比值。结果　恶性胸水组胸水及血清的CYFRA2 1— 1、CEA浓度均显著高于良性胸水组 (P <0 .0 1) ,且恶性胸水组中胸水的CYFRA2 1— 1、CEA浓度显著高于血清的CYFRA2 1— 1、CEA浓度 (P <0 .0 1)。胸水 /血清CYFRA2 1— 1比值 >4.5 ,胸水 /血清CEA比值 >1.2均提示恶性胸水可能性大。CYFRA2 1— 1检测恶性胸水 ,血清中敏感性为 60 .0 % ,特异性为 81.0 % ,胸水中敏感性为 92 .5 % ,特异性为 5 7.1% ;CEA检测恶性胸水 ,血清中敏感性为 5 5 .0 % ,特异性为 90 .5 % ,胸水中敏感性为 75 % ,特异性为 90 .5 %。CYFRA2 1— 1、CEA联合检测恶性胸水 ,血清中敏感性为 77.5 % ,特异性为 78.6% ,胸水中敏感性为 95 .0 % ,特异性为 85 .7%。结论　联合检测CYFRA2 1— 1、CEA对良恶性胸水具有良好的鉴别诊断价值。

Study on diagnostic value of analyzing CYFRA21-1 combined with CEA in benign and malignant pleural effusions

Objective To evaluate the diagnostic value of CYFRA21-1 combined with CEA measurement in benign and maligant pleural effusions.Methods CYFRA21-1 and CEA levels were measured with radio-immunoassay in the effusion and serum of 82 patients with pleural effusions.Results Effusion and serum concentration of CYFRA21-1 and CEA in with malignant pleural effusions in patients,were significantly higher than those with benign lung dieases(P<0.01).In patients with malignant pleural effusions,concentration of CYFRA21-1 and CEA in pleural effusions were significantly higher than that in serum (P<0.01).It is more likely malignant pleural effusions when the ratio of CYFRA21-1 in pleural effusions and serum is over 4.5,or,the ratio of CEA is over 1.2.The sensitivity and specificity of CYFRA21-1 for malignant pleural effusions were 60.0%,81.0% in the serum and 92.5%,57.1%,in the pleural effusions.The sensitivity and specificity of CEA for malignant pleural effusions were 55.0%,90.5% in the serum and 75.0%,90.5% in the pleural effusions.The sensitivity and specificity of CYFRA21-1 combined with CEA were 77.5%,78.6% in the serum and 95.0%,85.7% in the pleural effusions.Conclusions CYFRA21-1 combined with CEA measurement might be an useful index in differential diagnoisis of benign and malignant pleural effusions.