摘要
目的:探讨检测胸腔积液中腺苷脱氨酶(ADA)、降钙素原(PCT)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)对鉴别胸腔积液良恶性的诊断效能。方法:回顾性分析我院68例胸腔积液患者临床资料,按胸腔积液性质分为结核性胸腔积液组(41例)和恶性胸腔积液组(27例)。比较两组患者胸腔积液ADA、PCT、CEA、LDH水平,分析4项指标联合检测对结核性和恶性胸腔积液鉴别诊断的敏感性和特异性。结果:⑴结核性胸腔积液组中ADA、PCT明显高于恶性组,LDH、CEA明显低于恶性组,差异有统计学意义(P<0.05);⑵ADA、PCT、CEA、LDH四项指标ROC曲线下面积分别为0.95、0.86、0.99、0.78,以CEA曲线下面积最高。四项指标的诊断临界值分别是41.25 U/L、0.51 ng/L、11.26μg/L、335.76 U/L。灵敏度分别为82.9%、70.7%、99.1%、70.4%,以CEA灵敏度最高。特异性分别为96.3%、91.3%、92.7%、90.6%,以ADA特异性最高。结论:联合检测胸腔积液中ADA、CEA、LDH、PCT对鉴别胸腔积液良恶性具有重要意义。
Objective To investigate the diagnostic efficacy of detecting adenosine deaminase(ADA),procalcitonin(PCT),carcinoembryonic antigen(CEA),and lactate dehydrogenase(LDH)in pleural effusions to distinguish benign and malignant pleural effusions.Methods The clinical data of 68 patients with pleural effusion in our hospital were analyzed retrospectively.According to the nature of pleural effusion,they were divided into tuberculosis pleural effusion group(41 cases)and malignant pleural effusion group(27 cases).The levels of ADA,PCT,CEA and LDH in pleural effusion of the two groups were compared,and the sensitivity and specificity of the four indexes in the differential diagnosis of tuberculous and malignant pleural effusion were analyzed.Results⑴In the tuberculous pleural effusion group,ADA and PCT were significantly higher than those in the malignant group,and LDH and CEA were significantly lower than those in the malignant group.The differences were statistically significant(P<0.05).⑵The areas under the ROC curve of ADA,PCT,CEA and LDH were 0.95,0.86,0.99 and 0.78 respectively,with the highest area under the CEA curve.The diagnostic thresholds of the four indexes were 41.25 U/L,0.51 ng/L,11.26μg/L,and 335.76 U/L,respectively.The sensitivity were 82.9%,70.7%,99.1%,70.4%,with CEA having the highest sensitivity.The specificities were 96.3%,91.3%,92.7%and 90.6%respectively,with ADA being the most specific.Conclusion The joint detection of ADA,CEA,LDH and PCT in pleural effusion is of great significance to distinguish benign and malignant pleural effusion.
作者
张德博
潜力
谢九红
谢明水
ZHANG De-bo;QIAN Li;XIE Jiu-hong;XIE Ming-shui(Department of Medical Laboratory,Suizhou Hospital,Hubei University of Medicine,Suizhou,Hubei 441300,China)
出处
《湖北医药学院学报》
CAS
2020年第2期162-165,共4页
Journal of Hubei University of Medicine
关键词
生化指标
癌胚抗原
胸腔积液
诊断效能
Biochemical indicator
Carcinoembryonic antigen
Pleural effusion
Diagnostic efficacy
