胸水和血清CEA、ADA联合检测对恶性和结核性胸腔积液的诊断价值

目的 探讨联合检测胸腔积液血清中癌胚抗原（CEA）和腺苷脱氨酶(ADA)在恶性和结核性胸腔积液中的诊断价值.方法 对48例恶性胸腔积液和156例结核性胸腔积液的胸腔积液和血清ADA、CEA进行定量分析.结果 恶性胸腔积液和血清组癌胚抗原（CEA）明显高于结核性胸腔积液和血清组水平（P<0.01）；结核性胸腔积液和血清组腺苷脱氨酶(ＡＤＡ)明显高于恶性胸腔积液和血清组水平（P<0.01）；CEA在结核性和恶性胸腔积液中的阳性率分别为5.22%和86.36%,特异性13.64%和94.78％，ADA在结核性和癌性胸腔积液中分的阳性率分别为67.95％和6.25％，特异性93.75%和32.05％.结论　胸腔积液和血清ADA、CEA检测对恶性和结核胸腔积液均具有诊断与鉴别诊断价值.

Measuring CEA,ADA in Pleural Fluid and Serum Jointly for Differential Diagnosis Between Malignant and Tuberculous Pleural Effusion

Objective To determine the differential diagnosis value of carcinoembryonic antigen (CEA) and adenosine deaminase (ADA) measured jointly between malignant and tuberculous pleural effusion.Method ADA and CEA in pleural fluid and serum from 48 patients with malignant pleural effusion and 156 patients with tubeculous were determined.Results The value of CEA (pleural effusion/serum) in malignant pleural effusion was significantly higher than in tuberculous pleural effusion (P<0.01);While the value of ADA (pleural effusion/serum) in tuberculous was significantly higher than in malignant pleural effusion/serum.The positive rates of CEA in tuberculous and malignant pleural effusion were 5.22% and 86.36% respectively,and the specificity was 13.63% and 94.78%.The positive rates of ADA in tuberculous and malignant pleural effusion were 67.95% and 6.25% respectively,and specificity was 93.75% and 32.05%.Conclusion The detection of CEA and ADA is of great value in diagosing and differentiating tuberculous pleural effusion from malignant pleural effusion.