腺苷脱氨酶与癌胚抗原检测在胸腔积液诊断中的价值

目的分析腺苷脱氨酶（ADA）与癌胚抗原（CEA）检测在胸腔积液诊断和鉴别诊断中的应用价值。方法对46例自2008年9月～2009年6月我院经治有胸腔积液症状的患者检测胸腔积液和血清ADA、CEA水平,对不同疾病组结果分析比较。结果结核性胸腔积液组ADA为（43.00±13.82）U/L,CEA的含量为（1.25±1.22）μg/L;恶性胸腔积液组A-DA为（17.57±6.20）U/L,CEA为（293.74±197.50）μg/L。结核性胸腔积液组ADA含量较恶性胸腔积液组明显增高（P〈0.01）,恶性胸腔积液组CEA含量较结核性胸腔积液组明显增高（P〈0.01）。胸腔积液ADA（pADA）/血清ADA（sADA）及胸腔积液CEA（pCEA）/血清CEA（sCEA）比值,结核性胸腔积液组（2.69±0.83、1.05±0.89）与恶性胸腔积液组（0.87±0.22、9.47±5.91）相比有显著性差异（P〈0.01）,pADA及pCEA判断结核性胸腔积液的临界值分别为：39U/L、pCEA〈5μg/L,恶性胸腔积液的敏感性为95%、特异性为99.8%。结论胸腔积液腺苷脱氨酶与癌胚抗原测定对结核性胸腔积液和恶性胸腔积液的诊断具有重要价值。

The pleural effusion diagnosis value of adenosine deaminase and carcino embryonic antigen detection

Objective To investigate the diagnositic and differential diagnositic values in the adenosine deaminase（ADA）,carcino embryonic antigen（CEA） test for pleural effusion.Methods The levels of ADA and CEA in pleural fluid and serum in 46 patients with pleurisy were detected respectively and the ratio of the ADA,CEA levels in pleural fluid and in serum were calculated.The results of different groups of disease were compared with each other.Results The mean values of ADA in groups of tuberculous pleural effussion（43.00±13.82）U/L was significant higher than that of malignant pleural effussion（17.57±6.20）U/L（P〈0.01）,the mean values of CEA in groups of malignant pleural effussion（293.74±197.50）μg/L was significant higher than that of tuberculous pleural effussion（1.25±1.22）μg/L（P〈0.01）.The ratio of ADA and CEA in pleural effusion（pADA,pCEA） and in serum（sADA,sCEA） for group of tuberculous and maligant were statistical significance（P〈0.01）.The critical value of pADA and pCEA for diagnosis of tuberculous pleural effusion were 39U/L,pCEA 5μg/L（sensitivity were 94.5%,60%,specificity were 86.5%,95.3%） and malignant pleural effussion（sensitivity was 95%,specificity was 99.8%） respectively.Conclusion The values in the adenosine deaminase（ADA） and carcino embryonic antigen test for pleural effusion are valuable for diagnosis of tuberculous pleural effussion.