CAJ | 학술논문

[目的]研究端粒酶和CEA测定对鉴别良、恶性胸腔积液诊断的辅助效果。[方法]采用酶免疫分析法(enzymeimmunoassay，EIA)和端粒重复序列扩增酶联免疫吸附实验法(TRAP-PCR-ELISA)，分别测定良性胸腔积液38例(简称良性组)和恶性胸腔积液40例(简称恶性组)中的端粒酶活性和CEA水平。[结果]恶性组端粒酶活性和CEA的阳性率分别为80.00%(32/40)和85.00%(34/40)；良性组端粒酶活性和CEA的阳性率分别为7.89%(3/38)和0.00%(0/38),恶性组端粒酶和CEA的阳性率均比良性组显高，差异有统计学意义(χ2=40.96、57.26，P＜0.001)。端粒酶活性测定对恶性胸腔积液诊断的灵敏度与CEA相当，差异无显著意义(χ2=0.35、P＞0.05)。联合检测（恶性胸腔积液的诊断标准以其中1项阳性为参照）两项肿瘤标记物，则联合检测的灵敏度得97.50%(39/40)，明显高于CEA和端粒酶单项检测的灵敏度85.00%和80.00%，差异均有统计学意义(χ2=6.13、3.91，P＜0.01)。[结论]端粒酶和CEA测定对鉴别良恶性胸腔积液均有一定的价值，两者联合测定可提高诊断准确率。
[목적]연구단립매화CEA측정대감별량、악성흉강적액진단적보조효과。[방법]채용매면역분석법(enzymeimmunoassay，EIA)화단립중복서렬확증매련면역흡부실험법(TRAP-PCR-ELISA)，분별측정량성흉강적액38례(간칭량성조)화악성흉강적액40례(간칭악성조)중적단립매활성화CEA수평。[결과]악성조단립매활성화CEA적양성솔분별위80.00%(32/40)화85.00%(34/40)；량성조단립매활성화CEA적양성솔분별위7.89%(3/38)화0.00%(0/38),악성조단립매화CEA적양성솔균비량성조현고，차이유통계학의의(χ2=40.96、57.26，P＜0.001)。단립매활성측정대악성흉강적액진단적령민도여CEA상당，차이무현저의의(χ2=0.35、P＞0.05)。연합검측（악성흉강적액적진단표준이기중1항양성위삼조）량항종류표기물，칙연합검측적령민도득97.50%(39/40)，명현고우CEA화단립매단항검측적령민도85.00%화80.00%，차이균유통계학의의(χ2=6.13、3.91，P＜0.01)。[결론]단립매화CEA측정대감별량악성흉강적액균유일정적개치，량자연합측정가제고진단준학솔。
Objective] To study the determination of telomerase and CEA in differentiating benign and malignant pleural effusions. [Methods] Telomeric repeat amplification ELISA method(TRAP- PCR-ELISA) and enzyme immunoassay(EIA) were measured in 40 patients with malignant pleural effusion and 38 cases of benign pleural effusion telomeres activity and CEA levels. [Results] The telomerase activity in pleural effusions and CEA positive rate in malignant pleural effusion group were 80.0%(32/40) and 85%(34/40), benign pleural effusion group was 7.9%(3/40) and 0%(0/38), malignant pleural effusion of telomerase and CEA-positive rate was significantly higher than benign pleural effusion group, the difference was significant(χ2=40.96,57.26, P<0.001).Determination of telomerase activity in malignant pleural effusion diagnostic sensitivity and specificity of CEA rather, the difference was not statistical y significant(χ2=0.35, P>0.05). Two combined detection of tumor markers in terms of a positive diagnosis of malignant pleural effusion as the standard, the combined detection sensitivity was 97.5%(39/40), significantly higher than the telomerase and CEA single detection sensitivity 80% and 85%, the differences were statistical y significant(χ2=6.13,3.91,P<0.01). [Conclusion] Detection of the TA and CEA in pleural effusion is of a definite value in differentiating benign from malignant pleural effusion, and the detection of TA is more sensitive and specific than detection of CEA. Combining detection of both markers may raise the accuracy of the diagnosis.