血清及胸液中肿瘤标志物联合检测对肺癌引起胸腔积液临床意义研究及比较.docVIP

血清及胸液中肿瘤标志物联合检测对肺癌引起胸腔积液临床意义研究及比较【摘要】 目的 探讨胸腔积液患者血清和胸水中癌胚抗原（CEA）、CYFRA21-1、神经元特异性烯醇化酶（NSE）的含量变化、对肺癌引起的胸腔积液诊断的临床意义及比较。方法 肺癌组和对照组患者共62例，分别测量其血清和胸水中的CEA、CYFRA21-1、NSE的含量，并进行比较。结果 肺癌组患者血清和胸水肿瘤标志物均明显高于对照组（P0．05）。对照组中胸水和血清各项指标比较差异无统计学无意义（P0．05）。结论 肺癌引起的胸腔积液肿瘤标志物检测胸水的阳性率要高于血清；而临床上联合检测肿瘤标志物对于肺癌诊断的意义更大。? 【关键词】 肺癌；恶性胸腔积液；肿瘤标志物；CEA；CYFRA21-1；NSE?? Analysis and comparison of the significance of measuring tumor maker inpleural effusions caused by lung cancer JIA Rong．Respiratory Department of East District,The Second Peoples Hospital,Lianyungang,jiangsu 222023,China ? 【Abstract】 Objective To explore the change of quantities and clinic significance of CEA，CYFRA21-1，NSE in serum and pleural effusions of patients with m alignant pleural effusions caused by lung cancer.Methods62 cases were divided into two groups; lung cancer group and pneumonia group; investigator measured and compared quantities of CEA,CYFRA21-1,NSE in serum and pleural effusions． ResultsIn lung cancer group tumor markers in serum and pleural effusions were obviously higher than pneumonia group (P0．05)． In pneumonia group, it was no significance for quantities of CEA、CYFRA21-1，NSE in pleural and serum effusions(P0．05)． ConclusionIn m alignant pleural effusions caused by lung cancer, the positive rate of tumor markers in pleural effusions was higher than that in serum; for the clinic work, there was great significance in diagnosis of lung cancer by measuring tumor markers in combining pleural effusions and serum． ? 【Key words】Lung cancer;M alignant pleural effusions;Tumor markers;CEA;CYFRA21-1;NSE? 恶性胸腔积液是由恶性肿瘤累及胸膜或胸膜本身肿瘤所致。而肺癌目前仍是恶性胸腔积液的首要发病原因（约占其病因的36%左右），肺癌患者以胸腔积液为首发临床表现者约占15%，其中以肺腺癌最常见（约70%可发生胸腔积液）[1]。胸腔积液患者可仅有胸腔积液的症状而不出现原发病灶表现，这就给诊断造成了很大的困难。肿瘤标志物已在临床广泛应用，对肺癌及其他各种肿瘤的诊断有明确的临床意义。目前国内外对血清肿瘤标志物测定探讨较多，而对胸水中肿瘤标志物检测的意义报道较少。本文联合检测血清和胸水中肿瘤标志物（ CEA、CYFRA21-1、NSE），以观察肿瘤标志物含量与肺癌之间的关系，了解血清和胸水肿瘤标志物含量对诊断的敏感性并进行比较，观察联合检测对肺癌诊断的敏感性。? 1 材料和方法? 1．1 研究对象 选自本院住院的肺癌伴恶性胸腔积液患者共32例,其中男20例,女12例;年龄37～80岁，平均59．2岁