联合糖链抗原-125、癌胚抗原及D-二聚体检测对良、恶性胸腔积液的诊断价值

目的探讨联合检测糖链抗原-125(CA125)、癌胚抗原(CEA)及D-二聚体(D-dimer,DD)对良、恶性胸腔积液鉴别诊断的价值。方法采集60例患者的血清、血浆和胸腔积液样本,其中恶性胸腔积液患者40例,良性胸腔积液患者20例,用放射免疫分析技术检测其血清和胸腔积液CA125、CEA的含量及用酶联免疫法检测血浆DD的含量。结果恶性胸腔积液组患者血清CA125、CEA和血浆DD水平均明显高于良性胸腔积液组(P<0·01);恶性胸腔积液组患者胸腔积液CA125、CEA水平明显高于良性胸腔积液组(P<0·01);CA125、CEA和DD联合检测的敏感性和特异性分别为96·9%(平行实验)、96·2%(序列实验)。恶性胸腔积液患者胸腔积液CA125和CEA及血清CA125和CEA均呈显著正相关(P<0·01);恶性胸腔积液患者血浆DD和胸腔积液CEA及CA125也均呈显著正相关(P<0·01)。结论联合CA125、CEA及血浆DD的检测对良、恶性胸腔积液的鉴别诊断具有重要的临床意义。

Diagnostic Value of Combination of CA125,CEA and D-Dimer in Patients with Benign and Malignant Pleural Effusion

Objective To evaluate the diagnostic value of assays in combination of cancer antigen 125 (CA125),carcinoembryonic antigen (CEA) and D-dimer in the patients with benign and malignant pleural effusion.Methods CA125 and CEA in pleural fluid and serum were measured by radioimmunoassay in 40 patients with malignant pleural effusion and 20 patients with benign pleural effusion,and plasma D-dimer was measured by enzyme-linked immunosorbent assay in the whole patients.Results Pleural fluid and serum levels of CA125 and CEA in the patients with malignant pleural effusion were significantly higher than those in the patients with benign pleural effusion(P<0.01).Plasma D-dimer in the patients with malignant pleural effusion was significantly higher than those with in the patients benign pleural effusion(P<0.01).The sensitivity and specificity of combination of CA125 and CEA in pleural fluid and plasma D-dimer were 96.9% and 96.2% respectively.CA125 was positively correlated with CEA in both pleural fluid and serum of the patients with malignant effusion (P<0.01);Plasma D-dimer in the patients with malignant pleural effusion was positively correlated with CEA and CA125 in pleural fluid (P<0.01).Conclusion Combining assays of CA125,CEA and plasma D-dimer are of important significance for differential diagnosis of benign and malignant pleural effusion.