摘要
目的研究胸腔积液腺苷脱氨酶(ADA)、血管内皮生长因子(VEGF)联合血清癌胚抗原(CEA)、糖类抗原125(CA125)鉴别良恶性胸腔积液的价值。方法对2022年1月至2023年9月住院治疗的188例胸腔积液患者进行回顾性研究,根据细胞学、经皮穿刺胸膜活检结果,按胸腔积液性质分为良性组(n=105)与恶性组(n=83)。检测比较2组胸腔积液ADA、VEGF及血清CEA、CA125水平,通过受试者工作特征(ROC)曲线分析胸腔积液ADA、VEGF及血清CEA、CA125单独诊断恶性胸腔积液的价值,Kappa一致性分析胸腔积液ADA、VEGF及血清CEA、CA125联合诊断恶性胸腔积液的准确率。结果良性组胸腔积液ADA水平[(54.47±8.96)U/L]高于恶性组[(21.49±5.37)U/L],胸腔积液VEGF及血清CEA、CA125水平[(213.46±35.27)ng/mL、(1.95±0.52)μg/mL、(324.59±9.26)U/mL]低于恶性组[(409.81±46.63)ng/mL、(21.39±3.54)μg/mL、(408.73±98.14)U/mL](P<0.05)。ROC曲线分析证实,胸腔积液ADA、VEGF及血清CEA、CA125对诊断恶性胸腔积液有一定价值,曲线下面积分别为0.880、0.871、0.892、0.796,均P<0.05。经Kappa一致性分析,胸腔积液ADA、VEGF及血清CEA、CA125联合诊断恶性胸腔积液的敏感度为0.943,特异度为0.867,准确率为0.910,Kappa=0.815。结论胸腔积液ADA、VEGF及血清CEA、CA125均可用于恶性胸腔积液的鉴别,四项联合检测对恶性胸腔积液具有较高的诊断价值。
Objective To study the value of adenosine deaminase(ADA),vascular endothelial growth factor(VEGF)combined with serum carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)in differentiating benign and malignant pleural effusion.Methods A retrospective study was conducted on 188 patients with pleural effusion hospitalized from January 2022 to September 2023.According to cytology and percutaneous pleural biopsy results,they were divided into benign group(n=105)and malignant group(n=83)according to the nature of pleural effusion.ADA,VEGF in pleural effusion and serum CEA and CA125 levels were detected and compared between the two groups.The value of ADA,VEGF and serum CEA and CA125 in the diagnosis of malignant pleural effusion was analyzed by receiver operating characteristic(ROC)curve.Kappa consistency was used to analyze the accuracy of ADA,VEGF and serum CEA and CA125 in the diagnosis of malignant pleural effusion.Results The ADA level of pleural effusion in benign group[(54.47±8.96)U/L]was higher than that in malignant group[(21.49±5.37)U/L],while the levels of VEGF and serum CEA and CA125 in pleural effusion[(213.46±35.27)ng/mL,(1.95±0.52)μg/mL,(324.59±9.26)U/mL]were lower than those in malignant group[(409.81±46.63)ng/mL,(21.39±3.54)μg/mL,(408.73±98.14)U/mL](P<0.05).ROC curve analysis confirmed that ADA,VEGF,serum CEA and CA125 had certain value in the diagnosis of malignant pleural effusion,and the areas under the curve(AUC)of the above indicators were 0.880,0.871,0.892 and 0.796,respectively(all P<0.05).According to Kappa consistency analysis,the sensitivity of ADA,VEGF,serum CEA and CA125 in the diagnosis of malignant pleural effusion was 0.943,the specificity was 0.867,the accuracy was 0.910,and Kappa=0.815.Conclusion ADA,VEGF in pleural effusion and serum CEA and CA125 can be used in the differentiation of malignant pleural effusion.The combined detection of ADA,VEGF and CA125 can be used in the diagnosis of malignant pleural effusion.
作者
张庭秀
胡绳
马李杰
肖贞良
ZHANG Tingxiu;HU Sheng;MA Lijie;XIAO Zhenliang(Department of Respiratory and Critical Care Medicine,General Hospital of Western War Zone,Chengdu 610083,China)
出处
《临床误诊误治》
CAS
2024年第13期35-39,共5页
Clinical Misdiagnosis & Mistherapy
基金
四川省卫生和计划生育委员会科研课题(18PJ020)。
关键词
胸腔积液
良恶性
腺苷脱氨酶
血管内皮生长因子
癌胚抗原
糖类抗原125
诊断
鉴别
受试者工作特征曲线
Pleural effusion
Benign and malignant
Adenosine deaminase
Vascular endothelial growth factor
Carcinoembryonic antigen
Carbohydrate antigen 125
Diagnosis,differential
Receiver operating characteristic curve
