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目的探讨胸水原癌基因C-erbB-2和癌胚抗原CEA联合检测对良、恶性胸腔积液的鉴别诊断价值。方法 C-erbB-2采用酶联免疫吸附法(ELISA)、CEA采用电化学发光法(ECLI)对80例恶性胸水、40例良性胸水,分别进行C-erbB-2、CEA含量检测。结果 C-erbB-2、CEA在恶性胸水组中的含量分别为(5.45±1.92)ng/ml、(44.36±10.34)ng/ml均明显高于良性胸水组(1.87±0.23)ng/ml和(6.35±2.12)ng/ml。C-erbB-2、CEA单项检测灵敏度、特异性、准确度分别为77.5%、95.0%、83.3%和68.8%、82.5%、73.3%。C-erbB-2、CEA联合检测灵敏度93.3%、特异性78.3%、准确度78.3%。结论检测原癌基因C-erbB-2、CEA单项检测对良、恶性胸腔积液鉴别诊断均有较大临床价值,两项联合检测能大大提高检测灵敏度。
Objective To investigate the differential diagnosis of benign and malignant pleural effusions by combined detection of pleural fluid proto-oncogene C-erbB-2 and carcinoembryonic antigen CEA. Methods C-erbB-2 and CEA were detected by enzyme-linked immunosorbent assay (ELISA) in 80 cases of malignant pleural effusion and 40 cases of benign pleural effusion by electrochemiluminescence (ECLI). Results The levels of C-erbB-2 and CEA in malignant pleural effusion were (5.45 ± 1.92) ng / ml and (44.36 ± 10.34) ng / ml respectively, which were significantly higher than those in benign pleural effusion group (1.87 ± 0.23) ng / ml and (6.35 ± 2.12) ng / ml. Sensitivity, specificity and accuracy of single detection of C-erbB-2 and CEA were 77.5%, 95.0%, 83.3% and 68.8%, 82.5% and 73.3%, respectively. C-erbB-2, CEA joint detection sensitivity 93.3%, specificity 78.3%, accuracy 78.3%. Conclusion The detection of single oncogene C-erbB-2 and CEA has great clinical value in the differential diagnosis of benign and malignant pleural effusion. The two combined detection can greatly improve the detection sensitivity.