CAJ | 학술논문

目的探讨分析胸膜活检术联合癌胚抗原(CEA)、细胞学检查对不明原因胸腔积液的临床诊断价值.方法 176例不明原因胸腔积液患者作为研究对象,根据病理诊断结果将其分为2组:恶性胸腔积液组(恶性组,n=79)和结核性胸腔积液组(结核组,n=67).比较两组血清CEA、胸腔积液CEA、胸水CEA/血CEA及细胞学检查结果.结果 ①恶性组血清CEA、胸腔积液CEA、胸水CEA/血CEA高于结核组(P＜0.05);②细胞学检查的灵敏度和特异度分别是87.34％和100.00％,外周血CEA检查灵敏度和特异度分别是17.72％和49.25％,胸水CEA检查的灵敏度和特异度分别是58.23％和76.12％,胸水CEA/血CEA检查的灵敏度和特异度分别是77.22％和83.58％,不同检查结果的灵敏度和特异度组间比较差异有统计学意义(P＜0.05),其中细胞学检查灵敏度和特异度最高,其次是胸水CEA/血CEA检查,外周血CEA检查效果最差.结论胸膜活检术联合CEA、细胞学检查可以有效地检查不明原因胸腔积液的病因,并有助于良、恶性胸水的鉴别,值得临床推广应用.
목적 탐토분석흉막활검술연합암배항원(CEA)、세포학검사대불명원인흉강적액적림상진단개치.방법 176례불명원인흉강적액환자작위연구대상,근거병리진단결과장기분위2조:악성흉강적액조(악성조,n=79)화결핵성흉강적액조(결핵조,n=67).비교량조혈청CEA、흉강적액CEA、흉수CEA/혈CEA급세포학검사결과.결과 ①악성조혈청CEA、흉강적액CEA、흉수CEA/혈CEA고우결핵조(P＜0.05);②세포학검사적령민도화특이도분별시87.34％화100.00％,외주혈CEA검사령민도화특이도분별시17.72％화49.25％,흉수CEA검사적령민도화특이도분별시58.23％화76.12％,흉수CEA/혈CEA검사적령민도화특이도분별시77.22％화83.58％,불동검사결과적령민도화특이도조간비교차이유통계학의의(P＜0.05),기중세포학검사령민도화특이도최고,기차시흉수CEA/혈CEA검사,외주혈CEA검사효과최차.결론 흉막활검술연합CEA、세포학검사가이유효지검사불명원인흉강적액적병인,병유조우량、악성흉수적감별,치득림상추엄응용.
Objective To explore the clinical diagnostic value of pleural biopsy combined with carcinoembryonic antigen (CEA),cytology on patients with unexplained pleural effusion.Methods 176 patients with unexplained pleural effusion were divided into two groups by diagnostic results:malignant pleural effusion group (malignant group,n =79) and tuberculous pleural effusion group (tuberculous group,n =67).The serum CEA,pleural effusion CEA,pleural fluid CEA/serum CEA,and cytology were compared between the two groups.Results ① The serum CEA,pleural effusion CEA,pleural fluid CEA/serum CEA in the malignant group were significantly higher than those in the tuberculous group (P ＜0.05).②The sensitivity and specificity of cytology were 87.34％ and 100.00％,they were 17.72％ and 49.25％ by CEA of pleural effusion,they were 58.23％ and 76.12％ by CEA in peripheral blood,they were 77.22％ and 83.58％ by pleural fluid CEA/blood CEA.There was statistical significance on the sensitivity and specificity among different methods (P ＜0.05).The sensitivity and specificity of cytology were the highest,following by pleural fluid CEA/blood CEA,those of blood CEA were the lowest.Conclusions Pleural biopsy combined with CEA,cytology can effectively check the cause of unexplained pleural effusion,and help to identify benign and malignant pleural effusion,worthy of clinical application.