文章摘要
陆国军,张 宇,解卫平,曾晓宁,孔 辉,魏永越.ESM-1和CEA联合检测在鉴别良恶性胸腔积液中的价值[J].南京医科大学学报,2017,(1):77~80
ESM-1和CEA联合检测在鉴别良恶性胸腔积液中的价值
Diagnostic significance of combining determination ESM-1 with CEA level in differentiating malignant pleural effusion from tuberculous pleural effusion
投稿时间:2016-03-28  
DOI:10.7655/NYDXBNS20170116
中文关键词: ESM-1  CEA  胸腔积液  鉴别诊断
英文关键词: ESM-1  CEA  pleural effusion  differential diagnosis
基金项目:国家自然科学基金(81273571);南京市胸科医院青年人才基金
作者单位
陆国军 东南大学医学院附属南京胸科医院呼吸科江苏 南京 210029 
张 宇 东南大学医学院附属南京胸科医院呼吸科江苏 南京 210029 
解卫平 南京医科大学第一附属医院呼吸科江苏 南京 210029 
曾晓宁 南京医科大学第一附属医院呼吸科江苏 南京 210029 
孔 辉 南京医科大学第一附属医院呼吸科江苏 南京 210029 
魏永越 南京医科大学公共卫生学院统计学系江苏 南京 211166 
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中文摘要:
      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/mL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/mL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。
英文摘要:
      Objective: To investigate the diagnostic value of combining determination of ESM-1 and CEA levels in differentiating tuberculous(TPE) from malignant pleural effusion(MPE) caused by lung cancer. Methods: Totally 65 NSCLC patients with MPE and 45 patients with TPE were enrolled into this study. The ESM-1 level in pleural effusion was tested by ELISA and CEA levels were tested by the chemiLuminescence method. All results were analyzed by the statistical method. Results: The levels of ESM-1 and CEA in MPE was significantly higher than those in TPE(P<0.001). The sensitivity of ESM-1 testing for diagnosing MPE was 81.5%, the specificity was 84.60% and the accuracy was 82.73%. The sensitivity of CEA testing was 73.80%, the specificity was 95.60%, and the overall accuracy was 82.73%. The sensitivity of the combined testing was 83.10%, the specificity was 96.30%, and the overall accuracy was 82.73%. The sensitivity and the overall accuracy of combined testing were higher than those by ESM-1 and CEA testing single. Conclusion: MPE presents higher ESM-1 concentration than TPE does,and determination of ESM-1 is useful to differentiate MPE from TPE. The combined testing of ESM-1 with CEA can increase the sensitivity of diagnosis of MPE.
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