摘要
目的研究肿瘤标志物在良恶性胸腹水的临床鉴别价值。方法169例恶性胸腹水患者设为恶性腹水组，146例良性胸腹水设为良性组，比较两组胸腹水癌胚抗原（CEA）、甲胎蛋白（AFP）、糖类抗原（CA）125、CA19-9水平，并对各肿瘤标志物对良恶性胸腹水的诊断进行方法学评价。结果恶性组的CEA为（139．7±56．4）ng/mL、AFP为（189．2±45．2）ns／mL、CA125为（314．74-86．2）U／mL、CA19-9为（158．5±24．2）U／mL，浓度均高于良性组，差异有统计学意义（均P〈0．05）；ROC曲线分析CEA、AFP、CAl25以及CA19-9曲线下面积分别为0．811、0．547、0．715和0．769，其对应的诊断切点分别为5．6ng／mL、63．7ng／mL、38．9U／mL和30．4U／mL；AFP因ROC曲线下面积过低不适于恶性胸腹水的诊断。三种肿瘤标志物单独检测方法学评价的各项指标均以CEA最好，灵敏度为75．7％，特异度为88．6％，联合检测以CEA、CA125以及CA19-9的联合检测效果较好，灵敏度为80．5％，特异度为94．0％。结论肿瘤标志物联合检测对胸腹水的性质鉴别方面有重要的临床应用价值。
Objective To study the clinical value of tumor markers in differentiating benign and malignant pleural effusion and ascites. Methods To select 169 cases with malignant pleural effusion and ascites as malignant group, and 146 cases with benign ascites as benign group. The levels of pleural fluid carcinoembryonic antigen （CEA）, alpha fetoprotein （AFP）, carbohydrate antigen 125 （CA125）, carbohydrate antigen 19-9 （CA19-9） in the two groups were evaluated. And evaluate the method of diagnostic markers of benign and malignant hydrothorax and ascites on the tumor. Result CEA of malignant group was （ 159.7 ± 56.4） ng/mL, AFP was （189.2 ±45.2） ng/mL,CA125 was（31d.7 ±86.2）U/mL and CA19-9 was（158.5 ± 24.2）U/mL. The concentration is higher than the benign group, the difference was statistically significant （P 〈 0.05 ） ;then CEA, AFP,CA125 and CA19-9 under the curve were 0.811,0. 547,0.715,0. 769. The corresponding diagnostic levels were 5.6 ng/mL,63.7 ng/mL,38.9 U/mL,30.4 U/mE. So AFP was not suitable for the diagnosis of malignant pleural effusion and ascites for the low area under the ROC curve. CEA was the best indicator for evaluation of tumor in three tumor markers,and the sensitivity was 75.7%, specificity was 88.6%. CEA, CA125 and CA19-9 combined detection effect was better in the combined detection, the sensitivity was 80.5% and specificity was 94%. Conclusion Combined detection of tumor markers have important clinical application value of the nature of identification of hydrothorax and ascites.
出处
《国际免疫学杂志》
CAS
2015年第4期340-342,共3页
International Journal of Immunology
关键词
肿瘤标志物
胸腹水
恶性
良性
Tumor marker
Pleural effusion and ascites
Malignant tumor
Benign
作者简介
通信作者：张盟，Email：zh13963087345@126．com
