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目的 探讨肿瘤标志物联合检测在良、恶性胸腔积液鉴别诊断中的临床意义。方法 采集有胸腔积液患者的血清及胸水样本各 79例 ,其中恶性胸腔积液患者 35例 ,良性胸腔积液患者 4 4例 ,用免疫放射法检测其血清及胸水CEA、CA15 3、SCC和CY2 11的含量。结果 恶性胸水组血清CEA、CA15 3、SCC和CY2 11的阳性率分别为 5 8.82 %、70 .5 9%、9.0 9%和 5 4 .2 0 % ,胸水CEA、CA15 3、SCC和CY2 11的阳性率分别为 75 .76 %、70 .6 7%、2 5 .93%和 96 .6 7% ,其中 ,肿瘤标志物CEA、CA15 3和CY2 11血清及胸水的阳性率明显高于良性胸腔积液组 (P <0 .0 2 ) ;两组含量的检测亦得出相似的结果。联合检测血清CA15 3+CY2 11,其诊断恶性胸腔积液的敏感度为 94 .2 8% ,特异度为 76 .93%。结论 肿瘤标志物CEA、CA15 3和CY2 11的联合检测 ,对胸腔积液的鉴别诊断有较好的临床价值 ,联合方式以CA15 3+CY2 11为佳。
Objective To explore the clinical significance of combined detection of tumor markers in the differential diagnosis of benign and malignant pleural effusions. Methods Serum and pleural effusion were collected from 79 patients with pleural effusion, including 35 patients with malignant pleural effusion and 44 patients with benign pleural effusion. Serum and pleural effusion CEA, CA15 3, SCC and CY2 11 content. Results The positive rates of CEA, CA15 3, SCC and CY2 11 in patients with malignant pleural effusion were 5 8.82%, 70.59%, 9.0 9% and 54.2% respectively. The positive rates of CEA, CA15 3, SCC and CY2 11 The positive rates were 75.76%, 70.67%, 25.93% and 96.67% respectively. The positive rates of CEA, CA15 3 and CY2 11 in serum and pleural effusion were significantly higher than those in benign Pleural effusion group (P <0. 02); two groups of tests also obtained similar results. The combined detection of serum CA15 3 + CY2 11 showed a sensitivity of 94.28% and a specificity of 76.93% for the diagnosis of malignant pleural effusion. Conclusions The combined detection of tumor markers CEA, CA15 3 and CY2 11 has good clinical value in the differential diagnosis of pleural effusion. The combination of CA15 3 + CY2 11 is preferable.