Tenascin-c和癌胚抗原检测在恶性胸腔积液中的诊断价值

目的探讨肌腱蛋白C(Tenascin C,Tn-C)和癌胚抗原(CEA)联合检测在肺癌所致胸腔积液中的表达及其临床意义。方法采用酶联免疫吸附(ELISA)法及电化学发光法分别检测60例肺部良性疾病所致胸腔积液和60例恶性胸腔积液中Tn-C和癌胚抗原(CEA)的表达,分析Tn-C蛋白的表达与临床特征及肺癌诊断的关系。结果恶性组患者胸腔积液中Tn-C的表达水平高于对照组(P0.05),Tn-C在胸水中的表达与患者的性别、吸烟状况、肿瘤大小、病理分期及病理分型无关(P0.05),与淋巴结的转移有关(P0.05);两组患者的Tn-C血清浓度无统计学差异(P0.05)。根据ROC曲线,以Tn-C浓度为41.508ng/ml为最佳诊断临界点,此点所对应的诊断恶性胸腔积液(MPE)敏感性为90%,特异度为46.67%,联合CEA诊断的灵敏度为80%,特异度为98.3%。结论 Tn-C在肺癌所致恶性胸腔积液中的表达水平较高,与CEA联合检测可提高恶性胸腔积液的诊断灵敏度及特异度,故Tn-C可作为肺癌诊断的良好标记物。

Diagnostic value of Tenascin-C and CEA in lung cancer with malignant pleural effusion

Objective To evaluate the diagnostic value of combined measurement Tenascin-C and CEA in serum and PE of lung cancer patients. Methods The expression of Tn-C and CEA was detected in 60 malignant pleural effusions(MPE)associated with lung cancer and 60 benign pleural effusion by enzyme-linked immunoadsor-bent assay and electrochemiiluminescence respectively. Results The expression of Tn-C in MPE were significantly higher than that in the control group(P<0. 05). There was no significant difference between the two plasma groups. No association was found between Tn-C and gender, smoking status, tumor pathological type and pathological stage (P>0. 05). The expression of Tn-C was associated with lymph node metastasis(P<0. 05). There was no signifi-cant difference in the expression of Tn-C in plasma between the two groups(P>0. 05). A receiver operating charac-teristic(ROC)curve analysis was carried out to assess the value of Tn-C and CEA in MPE from lung cancer patients. The cut-off values for Tn-C and CEA were defined at 41. 508 ng/ml and 5ng/ml, respectively. The sensitivity and specificity of Tn-C were 90% and 46. 67%, and the sensitivity and specificity of combined measurement of Tn-C and CEA increased to 80% and 98. 3%. Conclusion The expression of Tn-C in MPEs is higher than that in benign pleural effusions, and the combined detection of Tn-C and CEA can improve the sensitivity and specificity significant-ly, so Tn-C could be a good marker for the diagnosis of MPE with lung cancer.