CEA、CYFRA21-1、NSE、LDH在良恶性胸腔积液中的鉴别诊断价值

目的 探讨血清及胸腔积液中癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经特异性烯醇化酶(NSE)、乳酸脱氢酶(LDH)在良恶性胸腔积液鉴别诊断价值.方法 分析我院55例肺癌患者和53例良性胸腔积液患者的血清及胸腔积液中CEA、CYFRA21-1、NSE、LDH检测水平,并根据受试者工作特性(ROC)曲线建立合理的临床判断临界值及检测的敏感性和特异性.结果 恶性患者胸水CYFRA21-1、NSE、CEA、LDH的水平高于良性患者(P<0.05).胸水CEA、CYFRA21-1、NSE、LDH的敏感性和特异性分别为90.9、63.6、72.7、36.4%和98.1、83、67.9、88.7%.血清CEA、CYFRA21-1、NSE、LDH的敏感性和特异性分别为89.1、87.3 、32.1、25.5%和92.5、79.2、90.6、92.5%.结论 胸水中CYFRA21-1、NSE、CEA、LDH检测在良恶性胸腔积液鉴别诊断中具有一定临床价值.

The differential diagnosis value of CEA, CYFRA21-1, NSE and LDH in the blood and pleural fluid of patients with benign or malignant pleural effusion

Objective To determine the differential diagnosis value of the tumor markers Carcinoembryonic Antigen(CEA),Cytokeratin 19 fragment(CYFRA21-1),Neuron Specific Enolase(NSE) and LDH in the blood and pleural fluid of patients with benign or malignant pleural effusion.Methods We prospectively evaluated the value of CEA,CYFRA21-1,NSE and LDH in the blood and pleural fluid of 108 patients with pleural effusion.Of which,55 were diagnosed with malignant pleural effusion,and 53 were diagnosed with benign effusion.The optimum cut-off points resulting from the best sensitivity-specificity balance in the ROC curves were constructed.Results There were significant differences between malignant and benign cases for CEA and CYFRA21-1,in blood,and for CYFRA21-1、NSE、CEA、LDH in pleural fluid.In the pleural fluid,the sensitivity and specificity of CEA,CYFRA21-1,NSE and LDH was 90.9、63.6、72.7、36.4% and 98.1、83、67.9、88.7%,respectively.In the blood,the sensitivity and specificity was 89.1、87.3、32.1、25.5% and 92.5、79.2、90.6、92.5% for CEA,CYFRA21-1,NSE and LDH,respectively.Conclusions The results suggest that these markers might be useful in the differentiation between malignant and benign pleural effusion.