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1、华西医学2008,23(6)CN51-1356/R1321[文章编号]1002-0179(2008)06-1321-03肿瘤标记物CEA,CA125,CA199在良恶性胸腔积液ValueofTumormarkersCEA,CA125,CA199intheDifferentiate鉴别诊断中的价值DiagnosisofBenignandMalignantPleuralEffusion11,21,23美朗曲措,张永刚,范红MeiLangQuCuo,ZHANGYong-gang,FANHong(四川大学华西医院11呼吸内科;21实验医学科,四川成都610041)(11Respi
2、ratoryDepartment,21DepartmentofLabMedecine,WestChinaHospital,SichuanUniversity,Chengdu610041,China)摘要:目的:分析400例胸腔积液的病因分布特点,探讨胸水及血清肿瘤标记物检测对鉴别良恶性胸腔积液的意义。方法:分析400例胸腔积液住院患者的临床资料,采用化学发光免疫法检测胸水及血清中的CEA、CA125、CA199水平并进行统计分析。结果:400例胸腔积液中,良性233例(58.3%),其中主要以结核为主,共144例(6118%),其次为肺炎39例(1617%),心功能不全1
3、9例(812%),脓胸11例(417%),其他20例(815%)。恶性胸液156例(39%),原发性支气管肺癌131例(84%),乳腺癌6例(318%),其他恶性肿瘤19例(1211%),不明原因者11例(217%)。41～59岁之间恶性胸液占该年龄组的4213%。胸液中肿瘤标记物CEA、CA125、CA199水平恶性组高于良性组(P<0101)。结论:结核和肿瘤是导致胸腔积液的主要原因,能否尽快鉴别二者直接影响其治疗和预后。41～59岁之间恶性胸液的发生率占该年龄组4213%,应该引起重视。胸水中CEA、CA125、CA199三项指标联合检测,对恶性胸腔积液的敏感度为9
4、612%,特异度为9117%,准确度为9318%。联合检测CEA,CA125,CA199对鉴别良恶性胸腔积液有较高的临床价值。关键词:胸腔积液;结核;肿瘤标志物;CEA;CA125;CA199[中图分类号]R730143;R56113[文献标志码]AAbstract:Objective:Toanalysisthecauseofpleuraleffusion,discussthesignificanceofserumandeffusiontumormarkerindifferentiatediagnosisofpleuraleffusion.Methods:Theclini
5、calcasesof400hospitalizedpatientswithpleuraleffusionwerere2viewedandtheirCEA,CA125,CA199levelsinserumandpleuraleffusionweredetected.Results:Outofthe400pleuraleffu2sion,233werecaseswerebenign(5813%),144casesofwhichweretuberculosis(6118%),39caseswerePneumonia(1617%)and19caseswerecardiacinsu
6、fficiency(812%),Another156pleuraleffusionweremalignant(39%).131casesofwhichwerelungcarcinoma(84%),6casesweremastcarcinoma(318%)and19caseswereanothercarcinoma(1211%),11casescannotmakecleardiagnosis(217%).Caseswithmalignanteffusionbetween41～59yearsoldaccountedfor4213%.LevelsofCEA,CA125,CA19
7、9inmalignanteffusionwerehigherthanthatofbenign(P<0101).Conclusion:Tuberculosisandcarcinomaweretheimportantcausesofpleuraleffusion.Theagebetween41～59yearsoldwithmalignanteffusionaccountedfor4213%,whichisobvioushigherthanpreviousreports.CombinationofCEA,CA125andCA199i
