血管内皮生长因子及癌胚抗原对鉴别良恶性胸腔积液的意义.docVIP

血管内皮生长因子及癌胚抗原对鉴别良、恶性胸腔积液的意义 　　作者：钱卫星,王晓　　作者单位：浙江省嵊州市人民医院 嵊州 312400 　　【摘要】目的通过检测胸腔积液中血管内皮生长因子(VEGF)和癌胚抗原(CEA)的水平, 探讨对鉴别良、恶性胸腔积液的意义。[方法]采用酶联免疫吸附试验(ELISA)检测26例恶性胸腔积液和20例良性胸腔积液患者的胸腔积液VEGF和CEA含量。[结果]恶性胸腔积液VEGF含量为(625.3±280.2)pg/ml，良性胸腔积液VEGF的含量为(250.6±110.4)pg/ml，两者比较(P0.01); 恶性胸腔积液CEA的含量为(48.6±18.5)Μg/L，良性胸腔积液CEA的含量为(5.6±2.2)Μg/L，两者比较(P0.01)，恶性胸腔积液VEGF和CEA的含量均明显高于良性胸腔积液。胸水VEGF+胸水CEA对恶性胸腔积液诊断的特异性为95.0%，敏感性为69.2%。[结论]检测胸腔积液VEGF、CEA含量有利于良、恶性胸腔积液的鉴别诊断。 　　【关键词】 血管内皮生长因子;癌胚抗原;良性胸腔积液;恶性胸腔积液;鉴别 　　Abstract：[Objective] To investigate the significance of vascular endothelial growth factor(VEGF) and carcino embryonic antigen(CEA) in differentiating benign and malignant pleural effusions.[Methods]VEGF was detected using ELISA method in pleural effusion of 26 cases of malignant pleural effusions and 20 cases of benign pleural effusions.[Results]VEGF levels in the pleural effusion of malignant pleural effusion patients were(625.3±280.2)pg/ml ,benign pleural effusion patients were(250.6±110.4)pg/ml, the comparison difference had the significance(P0.01). CEA levels in the pleural effusion of malignant pleural effusion patients were (48.6±18.5)Μg/L, benign pleural effusion patients were(5.6±2.2)Μg/L, the comparison difference had the significance(P0.01). VEGF and CEA levels in the pleural effusion of malignant pleural effusion patients, significantly higher than those of benign patients with pleurl effusion.The peculiarity and sensitivity of VEGF and CEA in pleural effusion were 95.0% and 69.2%.[Conclusion]The detection of VEGF and CEA, as a clinical item, may play some role in differentiating benign and malignant pleural effusions. 　　Key words: vascular endothelial growth factor; carcino embryonie antigen; benign;malignant pleural efusiion; discriminate 　　胸腔积液是临床常见疾病，引起胸腔积液常见病因为结核性和恶性，目前临床上鉴别两者仍有困难。血管内皮生长因子(VEGF)，是近年来发现的一种新的肿瘤标志物，已证实与肿瘤生长、浸润、转移密切相关。新生血管是肿瘤快速生长的条件，并为肿瘤细胞进入血液和淋巴循环播散提供了直接途径。VEGF促进肿瘤新生血管及基质形成，而实体瘤和转移瘤的发展依赖于血管形成。癌胚抗原(CEA) 是公认的重要的肿瘤相关抗原，对内胚层分化而来的肿瘤，有较高的阳性