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目的探讨常用肿瘤标志物对良恶性胸腔积液的鉴别诊断价值。方法选取自2014年6月至2015年6月住院的69例渗出性胸腔积液患者,根据诊断结果分为良性组(39例)和恶性组(30例),对其临床资料进行比较,以ROC曲线、Logistic回归判断相关指标诊断恶性胸腔积液的价值。结果 2组在性别、胸痛、咯血、消瘦、白细胞计数、中性粒细胞比例、C-反应蛋白、胸水LDH、血清LDH,胸水/血清LDH、血清CA125方面差异无统计学意义,具有可比性;2组在年龄、发热、咳嗽、呼吸困难方面差异有统计学意义(P均<0.05);良性组血沉、胸水ADA显著高于恶性组,恶性组胸水CEA、血清CEA、胸水/血清CEA,胸水CA25,胸水/血清CA125,胸水CA199,血清CA199,胸水/血清CA199,血NSE、血Cyfra21-1均显著高于良性组。血Cyfra21-1,胸水CA125,胸水CEA曲线下面积依次为0.871,0.858,0.853。经Logistic回归分析,发热、胸水ADA升高,胸水/血清CEA≤1倾向良性胸腔积液的诊断。结论血Cy-fra21-1,胸水CA125,胸水CEA是诊断恶性胸腔积液较好的指标,发热、胸水ADA升高,胸水/血清CEA≤1倾向良性胸腔积液的诊断。
Objective To investigate the diagnostic value of common tumor markers in the differential diagnosis of benign and malignant pleural effusions. Methods Sixty-nine patients with exudative pleural effusion hospitalized from June 2014 to June 2015 were divided into benign group (n = 39) and malignant group (n = 30) according to the diagnosis results, and their clinical data were compared , With ROC curve, Logistic regression to determine the value of related indicators in the diagnosis of malignant pleural effusion. Results There was no significant difference between the two groups in sex, chest pain, hemoptysis, wasting, white blood cell count, neutrophil ratio, C - reactive protein, pleural effusion LDH, serum LDH, pleural effusion / serum LDH, serum CA125; There were significant differences in age, fever, cough and dyspnea between the two groups (all P <0.05). The ADA of benign group was significantly higher than that of malignant group, malignant pleural effusion CEA, serum CEA, pleural effusion / serum CEA, pleural effusion CA25, pleural fluid / serum CA125, pleural fluid CA199, serum CA199, pleural effusion / serum CA199, blood NSE, blood Cyfra21-1 were significantly higher than the benign group. Blood Cyfra21-1, pleural effusion CA125, pleural effusion CEA area under the order of 0.871,0.858,0.853. Logistic regression analysis, fever, elevated pleural effusion ADA, pleural effusion / serum CEA ≤ 1 propensity to diagnose benign pleural effusion. Conclusions Blood Cy-fra21-1, pleural effusion CA125 and pleural effusion CEA are better indicators of diagnosis of malignant pleural effusion, fever, elevated ADA of pleural effusion, and diagnosis of benign pleural effusion with CEA≤1 in pleural effusion / serum.