肿瘤标志物在良恶性胸水鉴别诊断中的应用

目的]通过对胸水和血清中癌胚抗原（CEA）、糖类抗原125（CA125）、糖类抗原19—9（CA19—9）、神经特异性烯醇化酶（NSE）和细胞角蛋白19片段（CYFRA21—1）的检测，探讨各指标在对伴胸水的肺部良、恶性疾病鉴别诊断中的价值。方法]采用化学发光法对40例肺癌患者和42例结核患者的胸水、血清进行了免疫蛋白定量分析。结果]肺癌组血清CEA，NSE和CYFRA21—1胸水CEA，CA19—9CYFRA及21—1明显高于结核组。胸水CEA和血清CEA、CYFRA21—1的ROC曲线下面积最大，诊断价值最高。联合检测血清CYFRA21—1＋CEA鉴别恶性胸水的特异性为100％，敏感度为90．5％。结论]检测血清及胸水的肿瘤标志物对鉴别良、恶性肺部疾病有重要价值。

APPLICATION OF TUMOR MARKER DETECTION IN PLEURAL EFFUSION FOR DIFFERENTIATION OF BENIGN DISEASES FROM MALIGNANTONES

Objective ] To study the diagnostic value of carcinoembryonic antigen （CEA） , cancer antigen 125 （CA125） , cancer antigen 19 - 9 （ CA19 - 9 ） , neuron - specific enolase （NSE） , cytokeratin 19fragments （ CYFRA21 - 1 ） of pleural effusion and serum for differentiating benign and malignant lung diseases. Methods] Immunoprotein quantity of CEA , CA125 , NSE, CA19 -9 andCYFRA21 - 1 was analyzed in pleural fluid and serum from patients with lung cancer （40 cases） and tuberculous pleurisy patients （42cases） by chemilu- minescence. Results] Patients with lung cancer were found to have significantly higher serum levls of CEA, NSE and CYFRA21 - 1 and pleural fluid levis of CEA, CA19 - 1 and CYFRE21 - 1 than patients with tuberculous pleurisy. CEA of pleural effusion and CYFRA21 - 1, CEAof serum had the largest area under the ROC curve in the group of patients with lung cancer. The senstivity of combined assay with serum CEA ＋ CYFRA in diagnosing malignant pleural effusion was 100% ,with the specificity of 90.5%. Conclusion] Detecting the concentrations of tumor marker in pleural effusion and serum is helpful to differentiate benign and malignant lung diseases.