肿瘤标志物CEANSECYFRA211在胸腔积液鉴别诊断中应用价值.docVIP

肿瘤标志物CEANSECYFRA211在胸腔积液鉴别诊断中应用价值 　　[摘要]目的 探讨胸腔积液中肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片断(CYFRA21-1)、神经元特异性烯醇化酶(NSE)检测在胸腔积液鉴别诊断中的价值。方法 应用电化学发光法对65例肺癌患者和28例良性对照者的血清和胸腔积液进行检测。结果 肺癌组血清和胸水三项肿瘤标志物水平明显高于良性对照组(P0.01);肺癌组胸水三项指标水平高于血清(P0.01);CEA对肺腺癌,NSE对小细胞肺癌,CYFRA21-1对肺鳞癌的阳性率高于其他单项(P0.05)。结论 胸腔积液CEA、NSE、CYFRA21-1检测有助于肺癌的诊断。 　　[关键词] 肺癌;肿瘤标志物;胸腔积液 　　[中图分类号] R734.2;R73-34 [文献标识码] A[文章编号] 1673-9701(2010)14-46-02 　　 　　Value of Tumor Markers CEA,NSE and CYFRA21-1 in Differential Diagnosis of Pleural Effusion 　　HONG XitianZHANG RuiliXU Qingxia 　　Henan Provincial Tumor Hospital,Zhengzhou 450008,China 　　 　　[Abstract] Objective To investigate the value of the detection of tumor markers carcinoembryonic antigen(CEA), cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)in the differential diagnosis of pleural effusion. Methods The serum and pleural effusion in 65 cases of lung cancer and 28 benign controls were detected by electrochemical luminescence. Results The levels of the three tumor markers in serum and pleural effusion of lung cancer group were significantly higher than those in serum and pleural effusion of benign control group(P0.01),the levels of three indicators in pleural effusion were higher than those in serum(P0.01) and the positive rates of CEA in lung adenocarcinoma,NSE in small cell lung cancer and CYFRA21-1 and in lung squamous cell carcinoma were higher than the rate of any other single one(P0.05). Conclusion The detection of pleural effusion CEA,NSE and CYFRA21-1 is helpful in the diagnosis of lung cancer. 　　[Key words] Lung cancer;Tumor marker;Pleural effusion 　　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发原因(约占36%),肺癌患者以胸腔积液为首发症状者约占15%[1]。目前对恶性胸腔积液的诊断主要依靠病理细胞学,其阳性率不能满足临床需要。笔者收集分析了来我院就诊的胸腔积液患者的肿瘤标志物检测结果,探讨肿瘤标志物在胸腔积液诊断中的应用价值。 　　1材料与方法 　　1.1材料来源 　　肺癌组为2007年6月~2009年8月来我院就诊的胸腔积液患者,经病理和/或细胞学诊断证实,共65例,年龄45~81岁,其中男48例,女17例。良性对照组为来我院就诊的患者及部分来自河南省胸科医院的患者共28例,其中结核性胸膜炎17例,炎性积液8例,肺心病3例。年龄55~79岁。其中男21例,女7例。 　　1.2检测方法 　　将临床送检的胸腔积液5mL及空腹静脉血2mL,离心(3000r/min 10min)后取