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目的探讨测定癌胚抗原（ＣＥＡ）、糖类抗原（ＣＡ５０、ＣＡ１９－９、ＣＡ１２５）对老年人良恶性胸腔积液的鉴别诊断价值。方法分别测定老年良性和恶性胸腔积液患者血清和胸水的ＣＥＡ、ＣＡ５０、ＣＡ１９－９、ＣＡ１２５水平，用并联法评价多项肿瘤标志物联合应用的诊断价值。结果恶性胸腔积液患者血清和胸水中ＣＥＡ、ＣＡ５０、ＣＡ１９－９水平分别为３１．６±８．５μｇ／Ｌ、２８．０±９．５ｋＵ／Ｌ、４０．５±１６．４ｋＵ／Ｌ和４８．２±９．４μｇ／Ｌ、４５．８±７．１ｋＵ／Ｌ、５４．０±１８．４ｋＵ／Ｌ，均显著高于健康对照组和良性胸液患者，且胸水／血清比值＞１。胸水ＣＡ１２５水平在良恶性胸腔积液之间差异无显著性。ＣＥＡ和ＣＡ５０联用时敏感性为８６．４％，再加ＣＡ１９－９的３项联用，则敏感性达９７．７％。结论ＣＥＡ、ＣＡ５０、ＣＡ１９－９中二项或三项联合检测有一定诊断意义，如结合胸液／血清比值＞１，则诊断意义更大。
Objective To investigate the differential diagnosis of benign and malignant pleural effusions in elderly patients with carcinoembryonic antigen (CEA) and carbohydrate antigen (CA50, CA19-9, CA125). Methods The levels of CEA, CA50, CA19-9 and CA125 in serum and pleural effusion of elderly patients with benign and malignant pleural effusions were determined respectively. The diagnostic value of multiple tumor markers in combination was evaluated by the parallel method. Results The serum levels of CEA, CA50 and CA19-9 in patients with malignant pleural effusion were 31.6 ± 8.5μg / L, 28.0 ± 9.5kU / L and 40.5 ± 16.4kU / L, respectively 48.2 ± 9.4μg / L, 45.8 ± 7.1kU / L and 54.0 ± 18.4kU / L, respectively, which were significantly higher than those in healthy control group and benign pleural effusion with pleural effusion / serum ratio> 1 . There was no significant difference in the level of pleural effusion CA125 between benign and malignant pleural effusions. Sensitivity of CEA to CA50 was 86.4%. When combined with CA19-9, the sensitivity was 97.7%. Conclusions The combined detection of two or three of CEA, CA50 and CA19-9 has some diagnostic significance. For example, the combination of pleural fluid / serum ratio> 1, the diagnostic significance is greater.