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目的探讨联合检测胸腔积液中CEA、CA15-3、CA19-9、β-HCG、TPA5种肿瘤标志物对鉴别诊断良恶性胸腔积液的价值。方法采用化学发光法检测恶性组、结核组和良性组患者胸腔积液中CEA、CA15-3、CA19-9、β-HCG、TPA的含量;并与CT和脱落细学检查进行比较,分析肿瘤标志物的诊断敏感性、特异性及其临床应用价值。结果恶性组胸腔积液中CEA、CA19-9、CA15-3、β-HCG含量明显高于结核组、良性组(P<0.01),其阳性检出率分别为:52.83%、47.17%、41.51%、43.40%;TPA在恶性组和结核组含量显著升高,明显高于良性组(P<0.01),TPA与任一项肿瘤标志物同时阳性诊断恶性胸腔积液敏感性为84.9%,特异性为87.69%,与CT和脱落细胞联合检测相当。结论胸腔积液中肿瘤标志物联合检测是CT和脱落细胞检查的有益补充,对恶性胸腔积液诊断具有良好的临床应用价值。
Objective To investigate the value of combined detection of 5 tumor markers of CEA, CA15-3, CA19-9, β-HCG and TPA in the differential diagnosis of benign and malignant pleural effusions in pleural effusion. Methods The levels of CEA, CA15-3, CA19-9, β-HCG and TPA in pleural effusion of malignant, tuberculous and benign patients were detected by chemiluminescence method. The levels of CEA, CA15-9, Diagnostic sensitivity, specificity and clinical value of markers. Results The positive rates of CEA, CA19-9, CA15-3 and β-HCG in malignant group were significantly higher than those in tuberculosis group and benign group (P <0.01), and the positive rates were 52.83%, 47.17% and 41.51 % And 43.40%, respectively. The content of TPA in malignant and tuberculous groups was significantly higher than that in benign group (P <0.01). The sensitivity of positive TPA and any tumor marker in the diagnosis of malignant pleural effusion was 84.9% Sex 87.69%, and CT and exfoliated cells combined detection. Conclusion Combined detection of tumor markers in pleural effusion is a useful complement to CT and exfoliative cytology. It has a good clinical value for the diagnosis of malignant pleural effusion.