癌症比值及癌胚抗原对恶性胸腔积液的诊断价值
Diagnostic value of cancer ratio and carcinoembryonic antigen in malignant pleural effusion
潘珍珍 1朱苗娟 1荣玉琼 1杨炯 1陈毅斐1
作者信息
- 1. 武汉大学中南医院呼吸与危重医学科 湖北 武汉 430071
- 折叠
摘要
目的:探讨血清乳酸脱氢酶(LDH)与胸腔积液腺苷脱氨酶(pADA)比值即癌症比值(CR)及胸腔积液癌胚抗原(pCEA)对恶性胸腔积液的诊断价值.方法:选取2020年至2022年112例胸腔积液患者,根据病因分成恶性胸腔积液(MPE)组52例和良性胸腔积液(BPE)组60例,使用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析CR、pCEA及两者联合对恶性胸腔积液的诊断性能并筛选最佳截断值.结果:MPE组的CR和pCEA值明显高于BPE组,CR截断值为 13.56时,表现出高敏感性(0.88)、特异性(0.77)和高AUC值(0.86)(P<0.000 1),pCEA截断值为 3.04 ng/mL时,表现出高敏感性(0.94)、高特异性(0.85)和高AUC值(0.94)(P<0.000 1).将CR及pCEA联合时,与单独使用CR相比,诊断的敏感性(0.96)、特异性(0.78)和AUC值(0.95)明显提高(P<0.000 1).结论:LDH与pADA比值CR在区分良恶性胸腔积液方面具有较高的诊断能力,当与pCEA联用时,诊断MPE的敏感性、特异性和诊断准确性明显提高.
Abstract
Objective:To explore the diagnostic value of the ratio of serum lactate dehydrogenase(LDH)to pleural effusion adenosine deaminase(pADA),namely the cancer ratio(CR),and pleural effusion car-cinoembryonic antigen(pCEA)on malignant pleural effusion(MPE).Methods:A total of 112 patients with pleural effusion from 2020 to 2022 were selected,and according to the etiology,they were divid-ed into the MPE group(52 cases)and benign pleural effusion(BPE)group(60 cases).The diagnostic performance of CR,pCEA,and their combination in benign and malignant pleural effusion was ana-lyzed by using the receiver operator characteristic(ROC)curve and area under the curve(AUC),and the best cutoff value was selected.Results:The values of CR and pCEA in the MPE group were sig-nificantly higher than those in the BPE group.When the cutoff value was 13.56,CR showed high sensitivity(0.88),specificity(0.77),and AUC(0.86)(P<0.000 1),while pCEA showed high sensi-tivity(0.94)when the cutoff value was 3.04 ng/mL.Compared with those of CR alone,the sensitivi-ty(0.96),specificity(0.78),and AUC value(0.95)of CR combined with pCEA were significantly improved(P<0.000 1).Conclusion:The ratio of LDH to pADA(CR)has a high diagnostic ability in differentiating benign and malignant pleural effusion.When combined with pCEA,the sensitivity,specificity,and diagnostic accuracy of MPE are significantly improved.
关键词
恶性胸腔积液/癌症比值/癌胚抗原/血清乳酸脱氢酶/腺苷脱氨酶Key words
Malignant Pleural Effusion/Cancer Rate/Carcinoembryonic Antigen/Serum Lac-tate Dehydrogenase/Adenosine Deaminase引用本文复制引用
基金项目
武汉大学中南医院优势学科培育项目(XKJS202011)
出版年
2024
NETL
NSTL
万方数据