腺苷脱氨酶 癌胚抗原在胸腔积液鉴别诊断中的价值

目的探讨腺苷脱氨酶（ADA）、癌胚抗原（CEA）在癌性胸腔积液、结核性胸腔积液及非结核良性胸腔积液鉴别诊断中的应用价值。方法同时测定癌性胸腔积液、结核性胸腔积液及非结核良性胸腔积液中ADA、CEA,并对数据进行分析。结果 （1）结核性胸腔积液ADA为48.00（34.73～59.18）U/L,高于癌性胸腔积液6.80（11.50～17.88）U/L]和非结核良性胸腔积液9.45（5.32～17.23）U/L],差异有统计学意义（P〈0.01）,癌性胸腔积液和非结核良性胸腔积液ADA比较差异无统计学意义（P〉0.05）。癌性胸腔积液CEA为47.80（11.54～900.00）μg/L,高于结核性胸腔积液0.93（0.37～1.88）μg/L]和非结核良性胸腔积液0.97（0.68～1.66）μg/L],差异有统计学意义（P〈0.01）,结核性胸腔积液与非结核性良性胸腔积液CEA比较差异无统计学意义（P〉0.05）。（2）ADA诊断结核性胸腔积液ROC曲线下面积为0.943;CEA诊断癌性胸腔积液ROC曲线下面积为0.927。结论胸腔积液ADA、CEA指标的测定,对胸腔积液性质的鉴别有较高的价值,可为临床诊断和治疗提供重要信息。

Value of adenosine deaminase and carcinoembryonic antigen in differential diagnosis of pleural effusion

Objective To analyze the value of adenosine deaminase(ADA) and carcinoembryonic antigen(CEA) in the differential diagnosis of malignant pleural effusion,tuberculous pleural effusion and non-tuberculous benign pleural effusion.Methods We simultaneously detected ADA and CEA in malignant pleural effusion,tuberculous pleural effusion and non-tuberculous benign pleural effusion and then analyzed the detected data.Results(1)ADA in tuberculous pleural effusion was higher than that in malignant pleural effusion and non-tuberculous benign pleural effusion with statistical difference(P<0.01).ADA in malignant pleural effusion and non-tuberculous benign pleural effusion had no statistical difference(P>0.05).CEA in malignant pleural effusion was higher than that in tuberculous pleural effusion and non-tuberculous benign pleural effusion with statistical difference(P<0.01).CEA in tuberculous pleural effusion and non-tuberculous benign pleural effusion had no statistical difference(P>0.05).(2)ADA′s area under the ROC curve in diagnosis of tuberculous pleural effusion was 0.943.CEA′s area under the ROC curve in diagnosis of malignant pleural effusion was 0.927.Conclusion The detection of ADA and CEA has high value in the differential diagnosis of pleural effusion,which provides important information for clinical diagnosis and treatment.