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目的:探讨胸腔积液中细胞内皮特异因子-1(malignant pleural effusion,ESM-1)、癌胚抗原(carcino embryonie antigen,CEA)联合检测对肺癌所致恶性胸腔积液(malignant pleural effusion,MPE)和结核性胸腔积液(tuberculous pleural effusion,TPE)的鉴别诊断价值。方法:收集110例胸腔积液患者,其中肺癌伴MPE 65例,TPE 45例,分别采用ELISA法和化学发光法对两组患者胸腔积液组的ESM-1和CEA水平进行测定,根据受试者工作曲线(ROC)计算临床诊断界值,并对结果进行统计分析。结果:MPE中ESM-1和CEA的水平明显高于TPE组,差异有统计学意义(P均<0.001)。ESM-1取19.58 ng/m L时,诊断MPE的敏感度、特异度和准确性分别为81.50%、84.60%、82.73%;CEA取8.52 ng/m L时,诊断MPE的敏感度、特异度和准确性分别为73.80%、95.60%和82.73%。二者联合检测的敏感度、特异度和准确性为83.1%、93.3%和82.73%。结论:MPE患者胸腔积液中ESM-1显著增高,ESM-1对MPE有一定的诊断价值,联合检测ESM-1和CEA可进一步提高MPE诊断敏感度。
Objective: To investigate the effect of combined detection of malignant pleural effusion (EMM) and carcinoembryonic antigen (CEA) in pleural effusion on malignant pleural effusion (MPE) And tuberculous pleural effusion (tuberculous pleural effusion, TPE) differential diagnosis. Methods: One hundred and ten cases of pleural effusion were collected. Among them, 65 cases of lung cancer with MPE and 45 cases of TPE were collected. The levels of ESM-1 and CEA in pleural effusion were determined by ELISA and chemiluminescence. Person working curve (ROC) to calculate the clinical diagnostic cutoff value, and make statistical analysis of the results. Results: The levels of ESM-1 and CEA in MPE were significantly higher than those in TPE group (all P <0.001). The sensitivity, specificity and accuracy of diagnosing MPE with ESM-1 of 19.58 ng / m L were 81.50%, 84.60% and 82.73%, respectively. When CEA was 8.52 ng / m L, the sensitivity, specificity And accuracy of 73.80%, 95.60% and 82.73% respectively. The combined sensitivity, specificity and accuracy of the two methods were 83.1%, 93.3% and 82.73% respectively. Conclusion: ESM-1 in pleural effusion of patients with MPE is significantly higher, and ESM-1 has certain diagnostic value for MPE. Combined detection of ESM-1 and CEA can further improve the diagnostic sensitivity of MPE.