胸水四项肿瘤标志物联检对恶性胸腔积液的诊断价值

目的 探讨联合检测胸水中的肿瘤标志物糖链抗原125(CA125)、糖链抗原19-9(CA199)、癌胚抗原(CEA)、肿瘤特异性生长因子(TSGF)对良、恶性胸腔积液的诊断价值.方法 采用酶联免疫吸附法(ELISA)和化学比色法检测胸水中的CA125、CA199、CEA、TSGF水平,并单项及联合计算四项肿瘤标志物的敏感性和特异性,并分析其在恶性胸腔积液诊断中的价值.结果 恶性组胸水中的CA125、CA199、CEA、TSGF的值均显著高于良性组(P<0.01),胸水四项联合检测可使恶性胸腔积液组的敏感性提高到95.8%,与胸水中单项肿瘤标志物的敏感性相比较,P<0.01,差异有统计学意义.特异性为82.3%,与单项检测的各组特异性相比,无明显下降,P＞0.05,差异无统计学意义.结论 联合检测胸水中的四项肿瘤标志物CA125、CA199、CEA、TSGF可提高对恶性胸腔积液诊断的敏感性,而特异性无明显下降.上述四项肿瘤标志物可作为良、恶性胸腔积液鉴别诊断的辅助指标.Abstract：Objective To study the role of co-detections of four tumor markers CA125,CA199,CEA and TSGF in differential diagnosis of benign and malignant pleural effusion.Methods The levels of CA125, CA199, CEA and TSGF in pleural effusion were detected by ELISA and colorimetry,the sensitivity and the specifity of the the single tumor marker and tumor markers combined assay were counted. Tle diagnostic value of combined assay of these four tumor markers was evaluated. Results Pleural fluid levels of CA125 ,CA199 ,CEA and TSGF in patients with malignant effusion were significantly higher than those patients in benign pleural effusions(P<0.01). Four tumor markers in pleural effusion increased the diagnostic sensitivity to 95.8% ,contrast with the sensitivity of the single tumor marker(P<0.01). While the specifity of those was 82.3%, not declining significantly (P＞0.05), compared with the specifity of the single tumor marker. Conclusions The combined assay of four tumor markers CA125, CA199, CEA and TSGF in pleural effusion increased the diagnostic sensitivity, while the specifity of those have no decrease significantly. The co-detections of four tumor markers in pleural effusion show great values in diagnosis and differential diagnosis for malignant and benign pleural effusion.

The value of combined detection of four tumor markers in pleural effusion in diagnosis for malignant pleural effusion

Pleural effusion Carcino embryonic antigen Carbohydrate antigen 19-9 Carbohydrate antigen125 Tumor specific growth factor