联合检测胸水ADA、CEA、CA125、CA153在结核性与恶性胸水中的鉴别诊断价值

目的探讨联合检测胸水ADA、CEA、CA125、CA153对结核性与恶性胸水的鉴别诊断价值。方法收集114例已确诊胸腔积液患者的胸水,其中恶性组胸水64例,结核性胸水50例,检测两组患者胸水ADA、CEA、CA125、CA153水平。结果恶性组ADA明显低于结核组,而CEA、CA125、CA153水平明显高于结核组,两者差异显著,具有统计学意义。CEA、CA125、CA153对恶性胸水诊断的敏感性分别为73.4%、81.2%、43.8%,特异性分别为84.0%、46.0%、88.0%,准确性分别为79.8%、63.2%、66.7%,三项联合检测可显著提高诊断敏感性(93.4%)。ADA对结核性胸水的敏感性、特异性、准确性分别为83.4%、91.5%、87.6%。结论联合检测胸水ADA、CEA、CA125、CA153有助于结核性与恶性胸水的鉴别诊断。

The differential diagnosis value of combined detection of hydrothorax ADA,CEA,CA125,CA153 in tuberculous and malignant pleural effusion

Objective To investigate the value of combined detection of hydrothorax ADA,CEA,CA125,CA153 in tuberculous and malignant pleural effusions.Methods 114 patients who had been diagnosed with pleural effusion,64 cases of malignant hydrothorax,50 cases of tuberculous hydrothorax,detection the levels of pleural effusion ADA,CEA,CA125,CA153 of two groups.Results ADA of malignant group was significantly lower than that of tuberculosis group,and levels of CEA,CA125,CA153 were significantly higher than that of tuberculous group,the difference was statistical significance.CEA,CA125,CA153 in malignant pleural effusion diagnosis sensitivity were 73.4%,81.2%,43.8%respectively,specificity were 84.0%,46.0%,88.0%respectively.Accuracy were 79.8%,63.2%,66.7%,three joint detection could significantly increase the diagnostic sensitivity(93.4%).Sensitivity,specificity,accuracy of ADA for tuberculous hydrothorax were 83.4%,91.5%,87.6%.Conclusion The combined detection of ADA,CEA,CA125,CA153 contribute to differential diagnosis of tuberculosis and malignant pleural effusion.