胸水C-erbB-2、CEA联合检测对肺癌的诊断价值

目的探讨胸水原癌基因C-erbB-2和癌胚抗原CEA联合检测对良、恶性胸腔积液的鉴别诊断价值。方法 C-erbB-2采用酶联免疫吸附法（ELISA）、CEA采用电化学发光法（ECLI）对80例恶性胸水、40例良性胸水,分别进行C-erbB-2、CEA含量检测。结果 C-erbB-2、CEA在恶性胸水组中的含量分别为（5.45±1.92）ng/ml、（44.36±10.34）ng/ml均明显高于良性胸水组（1.87±0.23）ng/ml和（6.35±2.12）ng/ml。C-erbB-2、CEA单项检测灵敏度、特异性、准确度分别为77.5%、95.0%、83.3%和68.8%、82.5%、73.3%。C-erbB-2、CEA联合检测灵敏度93.3%、特异性78.3%、准确度78.3%。结论检测原癌基因C-erbB-2、CEA单项检测对良、恶性胸腔积液鉴别诊断均有较大临床价值,两项联合检测能大大提高检测灵敏度。

The Diagnostic Value of Combined Detection of C-erbB-2 and CEA in Chest Fluid to Lung Cancer

Objective To elucidate the diagnostic value of combined detection of C-erbB-2 and CEA in pleural fluid and develop diagnostic application for malignant and benign pleural effusion differentiation. Methods C-erbB-2 and CEA were deteeted by ELISA and ECLI in 80 cases of malignant pleural effusion and 40 cases of benign pleural effusion analysis. Results The mean level of C-erbB-2 and CEA in malignant effusions were(5.45±1.92) ng/ml and(44.36±10.34)ng/ml vespecbirely,and significantly higher than they in benign pleural effusions which were(1.87±0.23)ng/ml and(6.35±2.12)ng/ml respectively.The diagnostic sensitivity of C-erbB-2 for malignant pleural effusion was 77.5%,specifity was 95.0%,accuracy was 83.3%.The diagnostic efficiency of CEA are as follows: sensitivity 68.8%,specifity 82.5%,accuracy 73.3%.The combined sensitivity of C-erbB-2 and CEA for malignant pleural effusion was 93.3%,specifity was 78.3%,accuracy was 78.3%. Conclusions Evaluation of C-erbB-2、CEA in chest fluid can improve the differential diagnosis of malignant pleural effusion from benign pleural effusion,and combined application C-erbB-2 and CEA can greatly improve the detection sensitivity.