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目的研究肿瘤标记物水平对胸腔积液的诊断及其病因的相关性。方法统计本院胸腔积液患者400例,其中良性积液233例,恶性积液156例,检测各组胸腔积液及血清中CA125、CA19-9和CEA等肿瘤标志物及ADA水平,并应用t检验、ROC曲线等进行统计学分析。结果纳入的389例患者中良性组(233例)占58.3%,恶性积液组(156例)占39.0%,其中前5位病因分布依次为结核性胸膜炎、支气管肺癌、肺炎、心力衰竭、脓胸。恶性胸腔积液组患者胸水、血清肿瘤标志物水平明显高于良性组,差异有统计学意义(P<0.05)。CA19-9+CA125+CEA联合检查可提高良恶性胸腔积液鉴别的特异度及敏感度。结论 CA19-9、CA125和CEA联合检测,结合影像学、PPD实验有利于鉴别肿瘤与结核性胸膜炎引起胸腔积液的临床诊断。
Objective To study the correlation between the level of tumor markers and the diagnosis of pleural effusion and its etiology. Methods 400 cases of pleural effusion in our hospital were collected, including 233 cases of benign effusion and 156 cases of malignant effusion. Tumor markers and ADA levels of pleural effusion and serum CA125, CA19-9 and CEA in each group were detected and applied t test, ROC curve and other statistical analysis. Results Among the 389 patients enrolled, benign group (233 cases) accounted for 58.3% and malignant effusion group (156 cases) accounted for 39.0%. The top five causes were tuberculous pleurisy, bronchial lung cancer, pneumonia, heart failure, pus chest. Malignant pleural effusion patients pleural effusion, serum tumor markers was significantly higher than the benign group, the difference was statistically significant (P <0.05). CA19-9 + CA125 + CEA joint examination can improve the specificity and sensitivity of benign and malignant pleural effusion. Conclusions The combined detection of CA19-9, CA125 and CEA combined with imaging and PPD test is helpful to identify the clinical diagnosis of pleural effusion caused by tumor and tuberculous pleurisy.