纤维支气管镜活检联合肿瘤标志物检测对肺癌伴胸水的诊断价值

目的观察纤维支气管镜检查联合肿瘤标志物检测对肺癌的诊断价值。方法对63例肺癌伴胸水患者和63例肺部良性病变伴胸水患者行纤维支气管镜检查和血清及胸水肿瘤标志物癌胚抗原（CEA）、糖链抗原125（CA125）及细胞角蛋白19片段（CYFRA 21-1）检查。结果肺癌伴胸水患者血清及胸水CEA、CA125及CYFRA 21-1水平高于肺部良性病变伴胸水患者上述肿瘤标志物水平。纤维支气管镜活检的敏感性、特异性和准确性分别为73．0％、100．0％和86．5％，胸水三项肿瘤标志物检测联合纤维支气管镜活检的敏感性、特异性和准确性分别为87．3％、92．1％和89．7％，其中敏感性与单独的纤维支气管镜活检的敏感性的差异有统计学意义。结论纤维支气管镜检查联合胸水肿瘤标志物检测，可以提高肺癌的诊断率。

Clinical diagnosis value of fiberbronchoscope examination combined with tumor marker determination to lung cancer with pleural effusions

Objective To investigate the diagnosis value of fiberbronchoscope combined with tumor marker determination to lung cancer with pleural effusions. Methods By fiberbronchoscope and tumor marker, 63 cases with lung cancer and 63 cases with benign lung disease were studied for calculating the detectable sensitivity and specificity to lung cancer, then further evaluating the clinical value of FB examination combined with tumor marker in serum/pleural effusions of patients with lung cancer. Results In patients with lung cancer, the serum/pleural effusions levels of CEA, CA 125 and CYFRA 2121 were significantly higher than those in patients with benign lung diseases. The sensitivity, specificity and overall accuracy of fiberbronchoseope examination were 73.0%, 100. 0% and 86.5%, respectively. The sensitivity, specificity and overall accuracy of fiberbronchoseope examination combined with tumor marker were 87. 3 %, 92.1% and 89.7% , respectively. Conclusion The fiberbronchoseope examination is valuable in diagnosing lung cancer and by combined with tumor marker, it can further improve the accuracy for the diagnosis of lung cancer with pleural effusions.