五种肿瘤标志物联合检测对良恶性胸腔积液诊断价值.docVIP

五种肿瘤标志物联合检测对良恶性胸腔积液的诊断价值 　　【摘 要】目的：探讨联合检测胸腔积液中癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经原特异性烯醇化酶（NSE）、鳞状细胞癌抗原（SCC）和丙酮酸激酶M2型（TuM2-PK）5种肿瘤标志物水平在临床诊断良恶性胸腔积液中的应用价值。方法：对67例临床已确诊的胸腔积液患者（恶性35例，炎性32例）的胸腔积液标本，采用化学发光法检测CEA、CYFRA21-1、NSE，用微粒子酶免发光法检测SCC水平，用酶联免疫吸附法检测TuM2-PK。结果：恶性胸腔积液患者5种肿瘤标志物平均水平均显著高于对照组（P0.05）。胸水CEA、CYFRA21-1、NSE、SCC、 TuM2-PK 5种肿瘤标志物单项检测的灵敏性和特异性分别为75.4、48.3、40.2、44.3、75.3%和100.0、82.2、96.8、97.1、94.5%。而单项肿瘤标志物检测胸腔积液CEA检测的准确度最高。以上5种肿瘤标志物联合检测敏感性、特异性、准确度和阳性预测值分别为94.3%、96.8%、89.8%和99.1%。结论：胸水CEA、CYFRA21-1、NSE、SCC、 TuM2-PK联合检测有利于良恶性胸腔积液的鉴别诊断，联合检测可以提高诊断的敏感性。 　　【关键词】胸腔积液；肿瘤标志物；联合检测；诊断价值 　　The differential diagnosis value of combined detection of five tumor markers in benign or malignant pleural effusion 　　[Abstract]Objective To investigate the application value of combined detection of carcinoembryonic antigen （CEA）， cytokeratin fragment 19 （CYFRA21-1）， neuron specific enolase （NSE）， squamous cell carcinomaantigen （SCC） and the tumor type M2-pyruvate kinase （TuM2-PK） is in order to improve the differential diagnosis for benign or malignant pleural effusion. Methods The levels of tumor markers （CEA， CYFRA21-1， NSE） in 35 maligant pleural effusion and 32 benign pleural effusion were detected by electrochemistry luminescent technique， SCC by Microparticle Enzyme Immunoassay （MEIA） and TuM2-PK by ELISA method. Results The levels of five tumor markers of in malignant pleural effusion were significantly higher than in benign pleural effusion （p0.05）. Sensitivity， specificity value of the separate detection of five tumor marker in the pleural effusion were 75.4%， 48.3%， 40.2%， 44.3%， 75.3% and were 100.0%， 82.2%， 96.8%， 97.1% and 94.5%. The CEA expression with pleural effusions had higher accuracy than the others single tumor mark detection. Sensitivity， specificity， accuracy and positive predictive value of the combined detection of five tumor marker were 94.3%， 96.8%， 86.8%and 99.1%， respectively. Conclusion The combined detection of five tumor markers was good for the different