CYFRA21-1、CA19-9、CEA及其联合检测在鉴别良恶性胸腔积液中的临床价值

摘要

目的 探讨肿瘤标志物细胞角蛋白片段(cytokeratin fragment antigen 21-1, CYFRA21-1)、糖链抗原19-9(carbohydrate antigen 19-9, CA19-9)、癌胚抗原(carcino-embryonic antigen, CEA)及其联合检测在鉴别良恶性胸腔积液中的临床价值. 方法 选择2013年10月-2015年10月于我院就诊的80例胸腔积液患者,其中良性胸腔积液患者30例,恶性胸腔积液患者50例. 采用电化学发光法检测CYFRA21-1、CA19-9和CEA,并对其水平及阳性率进行统计学分析.结果 50例恶性胸腔积液患者的CYFRA21-1、CA19-9和CEA水平及阳性率均显著高于良性胸腔积液患者, 差异均具有统计学意义(P均<0.05). 三项指标联合检测的敏感性、特异性、阳性预测值、阴性预测值和Youden指数均高于各项指标单独检测.结论 肿瘤标志物CYFRA21-1、CA19-9、CEA可作为诊断恶性胸腔积液的指标,联合检测对于鉴别良恶性胸腔积液具有较高的诊断价值,可为临床制定合理治疗方案提供科学依据.%Objective To discuss clinical value of detection and combined detection of cytokeratin fragment antigen 21-1(CYFRA21-1), CA19-9(carbohydrate antigen 19-9) and carcino-embryonic antigen (CEA) in the identification between benign and malignant pleural effusion. Methods 80 cases pleural effu-sion patients were collected in our hospital from October 2013 to October 2015 , which were divided into 30 cases benign pleural effusion patients and 50 cases malignant pleural effusion patients. Levels of CYFRA21-1 , CA19-9 and CEA were detected by electrochemiluminescence immunoassay. And all data were analyzed sta-tistically. Results Levels and positive rates of CYFRA21-1, CA19-9 and CEA in malignant pleural effusion patients were all higher than that of benign pleural effusion patients , and the differences all had statistical sig-nificance (Pall<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and Youden index of combined detection were all higher than that of single detection. Conclusion CYFRA21-1, CA19-9 and CEA can be used as the index to diagnosing malignant pleural effusion. And combined detection has higher diagnosis value in the identification between benign and malignant pleural effusion.