TB-Ab-IgG ADA和CEA对良恶性胸水鉴别诊断意义

目的　探讨胸水结核抗体 (TB-Ab-IgG)、腺苷脱氨酶 (ADA)、癌胚抗原 (CEA)联合检测对良恶性胸腔积液的鉴别价值。方法 采用DIGFA法、Giusti改良法和放射免疫法对 92例胸腔积液行胸水TB Ab IgG、ADA和CEA检测分析。 结果 TB Ab IgG在结核性、癌性和其它组胸腔积液中的阳性率分别是 81.8%、12 .8%和 1.1% ,特异性为 87.5 % ;ADA活性在结核性和癌性胸腔积液中分别为 (5 9.6± 2 8.8)U/L和 (2 4 .7± 11.5 )U/L(P <0 .0 1) ,CEA为 (8.5± 7.3)ng/mL和 (6 0 .2± 39.6 )ng/mL(P <0 .0 1) ,ADA在其它组胸腔积液中为 (44 .6± 2 6 .5 )U /L ,与结核性胸腔积液相比 (P >0 .0 5 )。结论 胸腔积液TB Ab IgG、ADA、CEA检测对良恶性胸腔积液有鉴别价值。

Measuring TB-Ab-IgG,ADA and CEA for differentiation diagnosis value of bening and malignant pleural exudate

Objective To determine the differential diagnosis value of Mycobacterium tuberculosis antibody (TB-Ab-IgG),carcinoembryonic antigen (CEA) and adenosine deaminase (ADA) between benign and malignant pleural exudate.Methods The TB-Ab-IgG measured by DIGFA,ADA activity by the modified Giusti assays and CEA measured by IRMA in 92 cases of pleural exudate were analyzed.Results The positive rates of TB-Ab-IgG of tuberculous,malignant exudate and other group were 81.8%, 12.8% and 1.1% respectively,the specificity was 87.5%;the ADA activity of tuberculous and malignat exudate was (59.6±28.8)U/L and (24.7±11.5)U/L( P <0.01).The CEA levels were (8.7±7.3)ng/ml and (60.2±39.6)ng/ml( P <0.01);While the ADA activity of other group was (44.6±26.5)U/L,Compared with tuberculous exudate ( P >0.05).Conclusion The test of TB-Ab-IgG,ADA and CEA of pleural exudate is of great value of differentiate benign from malignant exudate.