ADA和CEA在诊断良性恶性胸腹水中的价值

目的探讨胸腹水腺苷脱氨酶(ADA)和癌胚抗原(CEA)联合检测在鉴别诊断良恶性胸腹水中的价值.方法应用酶偶联测定法对20例结核性胸腹水、25例癌性胸腺水3例细菌性胸腹水进行胸腹水ADA(PADA)和血清ADA(SADA)测定,并同时检测胸腹水CEA和血清CEA.结果结核性胸腹水ADA活性及PADA/SADA比值均超过癌性和细菌性胸腹水(P＜0.01).以PADA＞40 U/L为诊断结核性胸腹水界限,其诊断率为85.0%,特异性为92.8%.以PADA/SADA＞1为结核性胸腹水诊断界限,其诊断率为95.0%,特异性为96.4%.CEA在癌性胸腹水中的诊断率为88.0%,特异性为91.3%.在血清中的诊断率为28.0%.均超过结核性和细菌性胸腹水(P＜0.01).结论胸腹水ADA和CEA的测定对诊断良恶性胸腹水有一定的价值.

The value of ADA and CEA in the diagnosis of benign and malignant chest and abdominal dropsy

Objective To probe the value of ADA and CEA in the diagnosis of benign and malignant chest and abdominal dropsy.Methods ADA and CEA in chest and abdominal dropsy of 20 cases of tubercular chest and abdominal dropsy,25 cases of cancer chest and abdominal dropsy,3 cases of bacterial chest and abdominal dropsy were measured.Results ADA and PADA/SADA in tubercular chest and abdominal dropsy were higher than those in bacterial chest and abdominal dropsy(P<0.01).The diagnosis ratio was 85% and specificity was 92.8% with PADA>40 u/L as the threshold of diagnosis of tubercular chest and abdominal dropsy in contrast with the diagnosis ratio of 95% and specificity of 96.4% with PADA/SADA>1 as the threshold.The diagnosis ratio of cancer chest and abdominal dropsy was 88% and specificity 91.3% by CEA.In serum,it was 28%.All of them were higher than that of chest and abdominal dropsy(P<0.01).Conclusion.The measurement of CEA and ADA in chest and abdominal dropsy is valuable to the diagnosis of benign and malignant chest and abdominal dropsy