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目的 探讨胸液糖链抗原 15 3(CA15 3)测定在良、恶性胸腔积液鉴别诊断中的临床价值。方法 采用全自动化学发光免疫分析技术对 35例恶性、33例良性胸腔积液患者进行血清及胸液CA15 3测定 ,并与同时测定胸液中的癌胚抗原 (CEA)和肿瘤细胞及闭式经皮胸膜活检方法进行对比分析。结果 在良、恶性胸腔积液患者中胸液CA15 3含量分别为 (2 3.1± 10 .3)kU/L和 (6 1.7± 4 0 .6 )kU/L ,两者比较有显著差异 (P<0 .0 0 5 ) ;在恶性胸腔积液患者中胸液和血清CA15 3含量分别为 (6 1.7± 4 0 .6 )kU/L和 (4 1.5± 2 3.1)kU/L ,两者比较有显著差异 (P <0 .0 1) ;胸液中CA15 3、CEA、肿瘤细胞测定和胸膜活检 4种检测方法在恶性胸腔积液患者中的阳性率分别为 6 8.0 % ,70 .7% ,4 6 .7%和 6 6 .7% ;在恶性胸腔积液患者诊断中的敏感度分别为 6 0 .0 % ,6 5 .7% ,4 2 .9%和 5 7.1% ;特异度分别为 90 .9% ,84 .8% ,10 0 %和 10 0 % ;Yonden指数分别为 0 .5 0 9,0 .5 0 5 ,0 .4 2 9和 0 .5 71;以上 4种检测方法联合检测 (并联实验 )可明显提高其诊断的敏感度、诊断准确性和Yonden指数。结论 胸液CA15 3测定在胸腔积液鉴别诊断中不失为一种无创、简便、实用、有较高临床价值的检测方法
Objective To investigate the clinical value of pleural fluid sugar chain antigen 15 3 (CA15 3) in the differential diagnosis of benign and malignant pleural effusions. Methods Serum and pleural fluid CA15 3 were measured in 35 patients with malignant and 33 patients with benign pleural effusion by automated chemiluminescence immunoassay. In addition, CEA and tumor cells in the pleural effusion were measured at the same time. Percutaneous pleural biopsy method for comparative analysis. Results The contents of CA15 3 in pleural effusion in benign and malignant pleural effusion were (2 3.1 ± 10.3) kU / L and (6 1.7 ± 4.06) kU / L, respectively, with significant difference (P <0.05). The levels of pleural fluid and serum CA15 3 in patients with malignant pleural effusion were (6 1.7 ± 40.6) kU / L and (41.5 ± 21.3) kU / L, respectively (P <0.01). The positive rates of CA15 3, CEA, tumor cell and pleural biopsy in pleural effusion in patients with malignant pleural effusion were 6 8.0% and 70.7, respectively %, 46.7% and 66.7%, respectively. The sensitivity in diagnosis of patients with malignant pleural effusion were 60.0%, 65.7%, 42.9% and 51.1% respectively. The sensitivity Degrees were 90.9%, 84.8%, 100% and 100% respectively. The Yonden indices were 0.509, 0.550, 0.42, and 0.571, respectively. The combination of detection methods (parallel experiments) can significantly improve the diagnostic sensitivity, diagnostic accuracy and Yonden index. Conclusion The determination of pleural fluid CA15 3 in the differential diagnosis of pleural effusion after a non-invasive, simple, practical, high clinical value detection method