南方医科大学学报2019，Vol.39Issue(2)：175-180,6.DOI:10.12122/j.issn.1673-4254.2019.02.08
胸腔积液与血清中的癌胚抗原及其比值对结核性与肺癌性胸腔积液的诊断价值
Detection of carcinoembryonic antigen levels in pleural effusion and serum and their ratio for differential diagnosis of pleural effusion resulting from tuberculosis and lung cancer
摘要
Abstract
Objective To study the clinical value of detecting carcinoembryonic antigen levels in pleural effusion (PCEA) and serum (SCEA) and their ratio (P/S) in the differential diagnosis of pleural effusions resulting from tuberculosis and lung cancer.Methods This retrospectively study was conducted among 82 patients with pleural effusion caused by pulmonary tuberculous (TB;control group) and 120 patients with pleural effusion resulting from lung cancer in our hospital between April, 2016 and March, 2018.PCEA, SCEA and P/S were compared between the two groups and among the subgroups of lung cancer patients with squamous cell carcinoma (SqCa), adenocarcinoma (ACA), small cell carcinoma (SCLC).The receiveroperating characteristic curve (ROC) analysis was used to confirm the optimal critical value to evaluate the diagnostic efficiency of different combinations of PCEA, SCEA and P/S.Results PCEA, SCEA and P/S were significantly higher in the overall cancer patients and in all the 3 subgroups of cancer patients than in the patients with TB (P＜0.05).The areas under the ROC curve of PCEA, SCEA and P/S were 0.925, 0.866 and 0.796, respectively;PCEA had the highest diagnostic value, whose diagnostic sensitivity, specificity, accurate rate, and diagnostic threshold were 83.33％, 96.34, 88.61％, and 3.26 ng/ml, respectively;SCEA had the lowest diagnostic performance;the diagnostic performance of P/S was between that of SCEA and PCEA, but its combination with SCEA greatly improved the diagnostic performance and reduced the rates of misdiagnosis and missed diagnosis.Parallel tests showed that the 3 indexes combined had significantly higher diagnostic sensitivity than each or any two of the single indexes (P＜0.05), but the diagnostic specificity did not differ significantly.The area under the ROC curve of combined detections of the 3 indexes was 0.941 for diagnosis of lung cancer-related pleural effusion, higher than those of any other combinations of the indexes.Conclusion The combined detection of PCEA, SCEA and P/S has a high sensitivity for diagnosis of lung cancer-related pleural effusion and provides important information for rapid and accurate diagnosis of suspected cases.关键词
胸腔积液/癌胚抗原/肺癌/结核性胸膜炎/临床诊断Key words
pleural effusion/carcinoembryonic antigen/lung cancer/tuberculous pleurisy/clinical diagnosis引用本文复制引用
李锐成,郜赵伟,董轲,王会平,张惠中..胸腔积液与血清中的癌胚抗原及其比值对结核性与肺癌性胸腔积液的诊断价值[J].南方医科大学学报,2019,39(2):175-180,6.基金项目
国家自然科学基金 (81772485) （81772485）
