CAJ | 학술논문

目的：分析甲胎蛋白（AFP）、癌胚抗原（CEA）、糖链抗原125（CA125）、神经元特异性烯醇化酶（NSE）、糖链抗原724（CA724）联合检测对恶性胸腹腔积液的诊断价值。方法以细胞病理学诊断为金标准，采用受试者工作特征曲线（ROC曲线）确定肿瘤标志物对291例恶性胸腹腔积液的诊断临界值，以135例良性胸腹腔积液为对照，研究肿瘤标志物单独及联合检测对恶性胸腹腔积液的诊断价值。结果 ROC曲线分析结果显示，CEA、CA724诊断恶性胸腹腔积液的ROC曲线下面积均超过0．7，具有较高诊断价值。CEA、CA724、NSE、CA125单独检测时，以CEA灵敏度（81．7％）、约登指数（0．64）、阴性预测值（67．7％）、阳性预测值（90．8％）较高，特异度则以NSE（82．9％）较高。联合检测的诊断灵敏度、约登指数、阴性预测值较单独检测均有不同程度的提高。结论 CEA对恶性胸腹腔积液具有较高的诊断价值，多肿瘤标志物联合检测可提高诊断灵敏度、约登指数、阴性预测值。
목적：분석갑태단백（AFP）、암배항원（CEA）、당련항원125（CA125）、신경원특이성희순화매（NSE）、당련항원724（CA724）연합검측대악성흉복강적액적진단개치。방법이세포병이학진단위금표준，채용수시자공작특정곡선（ROC곡선）학정종류표지물대291례악성흉복강적액적진단림계치，이135례량성흉복강적액위대조，연구종류표지물단독급연합검측대악성흉복강적액적진단개치。결과 ROC곡선분석결과현시，CEA、CA724진단악성흉복강적액적ROC곡선하면적균초과0．7，구유교고진단개치。CEA、CA724、NSE、CA125단독검측시，이CEA령민도（81．7％）、약등지수（0．64）、음성예측치（67．7％）、양성예측치（90．8％）교고，특이도칙이NSE（82．9％）교고。연합검측적진단령민도、약등지수、음성예측치교단독검측균유불동정도적제고。결론 CEA대악성흉복강적액구유교고적진단개치，다종류표지물연합검측가제고진단령민도、약등지수、음성예측치。
Objective To explore Diagnostic value of combined detection of alpha fetoprotein(AFP) ,carcino‐embryonic antigen (CEA) ,carbohydrate antigen 125(CA125) ,neurone specific enolase(NSE) and carbohydrate antigen 724(CA724) in malignant hy‐drothorax and hydroperitoneum .Methods According to the pathological diagnosis as gold standard ,receiver operating characteristic (ROC) curve was used to analyzed the cut‐off value for the diagnosis of malignant hydrothorax and hydroperitoneum in 291 pa‐tients ,and 135 patients with benign malignant hydrothorax and hydroperitoneum were enrolled as controls .Diagnostic value of sin‐gle and combined detection of tumor markers was analyzed .Results Area under the ROC curve of CEA and CA724 were higher than 0 .7 ,indicating that CEA and CA724 were with high diagnostic value .Among CEA ,CA724 ,NSE and CA125 ,used for single detection ,CEA was with high sensitivity(81 .7% ) ,Jorden index(0 .64) ,negative predictive value(67 .7% ) ,positive predictive value (90 .8% ) ,and NSE(82 .9% ) was with high specificity .Combined detection of tumor markers could increase diagnostic sensitivity , Jorden index and negative predictive value .Conclusion CEA could be with high diagnostic value of malignant hydrothorax and hydro‐peritoneum .Combined detection of tumor markers could increase diagnostic sensitivity ,Jorden index and negative predictive value .