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关键词：胸腔积液；癌胚抗原；抗原，肿瘤相关，碳水化合物
摘要 目的 探讨测定癌胚抗原(CEA)、糖类抗原(CA50、CA19-9、CA125)对老年人良恶性胸腔积液的鉴别诊断价值。 方法 分别测定老年良性和恶性胸腔积液患者血清和胸水的CEA、CA50、CA19-9、CA125水平，用并联法评价多项肿瘤标志物联合应用的诊断价值。 结果 恶性胸腔积液患者血清和胸水中CEA、CA50、CA19-9水平分别为31.6±8.5μg/L、28.0±9.5kU/L、40.5±16.4kU/L和48.2±9.4μg/L、45.8±7.1kU/L、54.0±18.4kU/L，均显著高于健康对照组和良性胸液患者，且胸水/血清比值>1。胸水CA125水平在良恶性胸腔积液之间差异无显著性。CEA和CA50联用时敏感性为86.4%，再加CA19-9的3项联用，则敏感性达97.7%。
结论 CEA、CA50、CA19-9中二项或三项联合检测有一定诊断意义，如结合胸液/血清比值>1，则诊断意义更大。
The diagnosticvalue of measurement of 4 tumor markers in the aged with benign and malignant pleuraleffusion
Li Jian, Hu Shengli, ZhangLanshi, et al. The Affiliated Hospital of Zhenjiang Medical College, Zhenjiang 212001
Abstract Objective Toevaluate CEA, CA50,CA19-9, and CA125 in the differential diagnosis of benign and malignantpleural effusion. Methods The 4 tumor markers in pleural fluid and serum were measured in 44aged patients with malignant effusion and 30 aged patients with benign effusion. Results Pleuralfluid and serum levels of CEA, CA50 and CA19-9 in the patients with malignant effusionwere significantly higher than in those with benign effusion with pleural fluid/serumratio>1. The pleural fluid level of CA125 inpatients with benign and malignant effusion did not show significant difference. Thesensitivity of CEA combined with CA50 were 86.4%. Combination of CEA, CA50 and CA19-9increased the sensitivity to 97.7%. Conclusions Combination of more tumor markers increases sensitivity indiagnosis. Use of pleural fluid/serum ratio of CEA, CA50 and CA19-9 improves diagnosticvalue further and provides useful information for differential diagnosis of benign andmalignant effusion in the aged.
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