摘要
目的探讨DNA异倍体联合肿瘤标志物检测在胸腔积液良恶性诊断中的价值。方法将53例胸腔积液分为恶性组(23例)和良性组(30例)。除常规细胞学检查外,以DNA细胞自动检测分析仪检测患者胸腔积液中的DNA异倍体,采用电化学发光法测定胸腔积液中癌胚抗原(CEA)、糖类抗原(CA125)肿瘤标志物含量。比较DNA异倍体联合肿瘤标志物诊断与细胞学诊断的优劣。结果 CA125(AUC=0.747)、CEA(AUC=0.882)、DNA(AUC=0.776)均有显著的诊断价值(P<0.001)。CA125取值为>563 U/ml时,最佳诊断灵敏度、特异度分别为72.73%、76.67%;CEA取值为>2.93μg/ml时,最佳诊断灵敏度、特异度分别为86.96%、86.67%;DNA取值为>0时,最佳诊断灵敏度、特异度分别为78.26%、73.33%;3个指标具有同样的诊断价值。将DNA异倍体、CEA、CA125检测结果进行联合诊断的灵敏度与单独诊断时的最佳灵敏度(指标CEA,86.96%)相近,同时其特异度优于3个指标独立诊断时特异度。结论DNA异倍体联合CEA、CA125检测诊断恶性胸腔积液灵敏度与单独诊断时的最佳灵敏度相近,但其特异度优于3个指标独立诊断时特异度。具有定量、快速、价廉、易标准化的特点,且操作简单。
Objective The aim of this study is to explore the diagnostic value of DNA aneuploidy combined with tumor markers in deter-mination of pleural effusions of malignant and benign origin. Methods 53 patients with pleural effusions were divided into the malignant group（ n=23）and benign group（n=30）. In addition to routine cytology,DNA aneuploidy in pleural effusion was detected with automatic DNA analyzer. The levels of tumor markers CEA and CA125 in pleural effusion were detected by electrochemiluminescence assay. The advantages and disadvanta-ges were compared between diagnostic values of DNA aneuploidy combined with tumor markers and cytology. Results CA125（AUC=0. 747）, CEA（AUC=0. 882）and DNA（AUC=0. 776）had significant diagnostic values（ P 〈0. 001）. When CA125〉563 U/ml,the optimum diag-nostic sensitivity and specificity were 72. 73% and 76. 67%,respectively. When CEA〉2. 93 μg/ml,the optimum diagnostic sensitivity and spe-cificity were 86. 96% and 86. 67%,respectively. When DNA〉0,the optimum diagnostic sensitivity and specificity were 78. 26% and 73. 33%, respectively. Three indicators had the same diagnostic value. The combined diagnosis of DNA aneuploidy,CEA and CA125 results had a similar sensitivity with the independent diagnosis（optimum sensitivity：CEA=86. 96%）and a superior specificity than the independent diagnosis. Con-clusion The combined diagnosis of DNA aneuploidy,CEA and CA125 results have a similar sensitivity with the independent diagnosis and a su-perior specificity than the independent diagnosis. This method is quantifiable,rapid,inexpensive and standardized,with simple procedures.
出处
《临床和实验医学杂志》
2014年第24期2037-2040,共4页
Journal of Clinical and Experimental Medicine
