胸腔积液ADA、VEGF及血清CEA、CA125鉴别良恶性胸腔积液的价值
Value of ADA,VEGF and Serum CEA and CA125 in Differentiating Be-nign and Malignant Pleural Effusion
张庭秀 1胡绳 1马李杰 1肖贞良1
作者信息
- 1. 610083 成都,西部战区总医院呼吸与危重症医学科
- 折叠
摘要
目的 研究胸腔积液腺苷脱氨酶(ADA)、血管内皮生长因子(VEGF)联合血清癌胚抗原(CEA)、糖类抗原125(CA125)鉴别良恶性胸腔积液的价值.方法 对2022 年1 月至2023 年9 月住院治疗的 188 例胸腔积液患者进行回顾性研究,根据细胞学、经皮穿刺胸膜活检结果,按胸腔积液性质分为良性组(n=105)与恶性组(n=83).检测比较2 组胸腔积液ADA、VEGF及血清CEA、CA125 水平,通过受试者工作特征(ROC)曲线分析胸腔积液ADA、VEGF及血清CEA、CA125 单独诊断恶性胸腔积液的价值,Kappa 一致性分析胸腔积液 ADA、VEGF 及血清 CEA、CA125 联合诊断恶性胸腔积液的准确率.结果 良性组胸腔积液 ADA 水平[(54.47±8.96)U/L]高于恶性组[(21.49±5.37)U/L],胸腔积液 VEGF 及血清 CEA、CA125 水平[(213.46±35.27)ng/mL、(1.95±0.52)μg/mL、(324.59±9.26)U/mL]低于恶性组[(409.81±46.63)ng/mL、(21.39±3.54)μg/mL、(408.73±98.14)U/mL](P＜0.05).ROC曲线分析证实,胸腔积液ADA、VEGF及血清CEA、CA125 对诊断恶性胸腔积液有一定价值,曲线下面积分别为0.880、0.871、0.892、0.796,均P＜0.05.经Kappa一致性分析,胸腔积液ADA、VEGF及血清CEA、CA125 联合诊断恶性胸腔积液的敏感度为0.943,特异度为0.867,准确率为0.910,Kappa=0.815.结论 胸腔积液ADA、VEGF及血清CEA、CA125 均可用于恶性胸腔积液的鉴别,四项联合检测对恶性胸腔积液具有较高的诊断价值.
Abstract
Objective To study the value of adenosine deaminase(ADA),vascular endothelial growth factor(VEGF)combined with serum carcinoembryonic antigen(CEA)and carbohydrate antigen 125(CA125)in differentiating be-nign and malignant pleural effusion.Methods A retrospective study was conducted on 188 patients with pleural effusion hos-pitalized from January 2022 to September 2023.According to cytology and percutaneous pleural biopsy results,they were di-vided into benign group(n=105)and malignant group(n=83)according to the nature of pleural effusion.ADA,VEGF in pleural effusion and serum CEA and CA125 levels were detected and compared between the two groups.The value of ADA,VEGF and serum CEA and CA125 in the diagnosis of malignant pleural effusion was analyzed by receiver operating characteris-tic(ROC)curve.Kappa consistency was used to analyze the accuracy of ADA,VEGF and serum CEA and CA125 in the di-agnosis of malignant pleural effusion.Results The ADA level of pleural effusion in benign group[(54.47±8.96)U/L]was higher than that in malignant group[(21.49±5.37)U/L],while the levels of VEGF and serum CEA and CA125 in pleural effusion[(213.46±35.27)ng/mL,(1.95±0.52)μg/mL,(324.59±9.26)U/mL]were lower than those in malignant group[(409.81±46.63)ng/mL,(21.39±3.54)μg/mL,(408.73±98.14)U/mL](P＜0.05).ROC curve analysis confirmed that ADA,VEGF,serum CEA and CA125 had certain value in the diagnosis of malignant pleural effusion,and the areas under the curve(AUC)of the above indicators were0.880,0.871,0.892 and 0.796,respectively(all P＜0.05).According to Kappa consistency analysis,the sensitivity of ADA,VEGF,serum CEA and CA125 in the diagnosis of malignant pleural effusion was 0.943,the specificity was 0.867,the accuracy was 0.910,and Kappa=0.815.Conclusion ADA,VEGF in pleural effusion and serum CEA and CA125 can be used in the differentiation of malignant pleu-ral effusion.The combined detection of ADA,VEGF and CA125 can be used in the diagnosis of malignant pleural effusion.
关键词
胸腔积液/良恶性/腺苷脱氨酶/血管内皮生长因子/癌胚抗原/糖类抗原125/诊断,鉴别/受试者工作特征曲线Key words
Pleural effusion/Benign and malignant/Adenosine deaminase/Vascular endothelial growth factor/Car-cinoembryonic antigen/Carbohydrate antigen 125/Diagnosis,differential/Receiver operating characteristic curve引用本文复制引用
基金项目
四川省卫生和计划生育委员会科研课题(18PJ020)
出版年
2024
国家科技期刊平台
NSTL
万方数据