肿瘤标志物CEA、CA125、CA199在恶性胸腔积液鉴别中的应用

目的对比病理学及细胞学检查，观察胸腔积液中CEA、CA199、CA125水平，探讨三种肿瘤标志物对恶性胸腔积液的鉴别诊断价值。方法入选36例良性胸腔积液患者及29例恶性胸腔积液患者，采用全自动化学发光法检测所有入选人群胸腔积液中CEA、CA199、CA125水平，并统计常用筛检试验指标，评价其鉴别诊断价值。结果恶性胸腔积液组CEA、CA125、CA199水平（117．83±139．43）μg／L、（51．26±22．71）U／ml、（138．29±152．31）U／Hll显著高于良性胸腔积液组（2．89±7．21）μg／L、（17．12±9．23）U／ml、（23．36±37．84）U／ml（P〈0．05）；筛检结果显示单纯检测三种标志物敏感性均较低，其中CEA敏感度58．6％为最高，CA199特异度94．4％为最高，三种标志物联合检测敏感度高达89．7％，P〈0．01，特异度为97．2％；在诊断一致性方面三种标志物联合检测Kappa值0．875为最高。结论单独检测CEA、CA125、CA199其CEA敏感性较高，CA199特异性较高；联合检测CEA、CA125、CA199其敏感性可产生最大叠加效应，高对恶性胸腔积液诊断效度，可作为胸腔积液良恶性鉴别诊断的辅助指标。

Tumor marker CEA, CA125, CA199 in the identification of malignant pleural effusion application

Objective To compare the pathology and cytology, pleural effusion observed in the CEA and CA199, CA125 levels to explore three types of tumor markers for malignant pleural effusion in the differenti-al diagnosis. Methods The selected 36 cases of patients with benign pleural effusion and 29 cases of patients with malignant pleural effusion. The use of fully automated chemiluminescence detection of all people selected in the pleural effusion CEA and CA199, CA125 levels and screening tests commonly used statistical indicators to e-valuate their differential diagnosis. Results malignant pleural effusion group CEA, CA125, CA199 level (117.83±139.43)μg/L, (51.26±22.71 U/ml), (138.29±152.31) U/ml were significantly higher than benign pleural effusion group (2.89±7.21)μg/L, (17.12±9.23) U/ml, (23.36±37.84)U/ml,(P<0.05). Screening results showed that a simple detection sensitivity of the three markers were lower, with sensitivity of the CEA 58.6 percent for the highest CA199 specificity of 94.4% percent for the highest of the three markers combined detection sensi-tivity as high as 89.7% P<0.01,specificity 97.2%. Consistency in the diagnosis of the three markers combined detection of Kappa as the supreme value of 0. 875. Conclusion Detection of a separate CEA, CA125, CA199 sen-sitivity of the CEA high CA199 more specific joint detection of CEA,CA125 ,CA199 may have a sensitivity of the effect of superimposed significantly improve the diagnosis of malignant pleural effusion validity. Can be used as be-nign and malignant pleural effusion differential diagnosis of secondary indicators.