肺癌患者胸腔积液中CEA及CA153的表达及意义

背景与目的常规细胞学查找肺癌患者胸腔积液中的癌细胞始终是难点。本研究拟通过检测肺癌患者血清和胸腔积液中癌细胞释放的癌蛋白，以弥补单纯细胞学检测的局限性，寻找一种更灵敏、准确的肺癌检测手段。方法采用化学发光分析仪对74例肺癌患者及34例非肺癌患者的血清和胸腔积液进行了免疫蛋白定量分析。结果肺癌组胸腔积液内CEA及CA153水平明显高于非肺癌组内水平（P〈0．01）；肺癌组血清内CEA及CA153水平亦明显高于非肺癌组内水平（P〈0．01）；肺癌组胸腔积液内CEA及CA153水平明显高于其血清内水平（P〈0．01）；在胸腔积液中，CEA与CA153联合检测为最佳组合，其敏感性和特异性分别高达85．1％和97．1％。结论检测肺癌患者胸腔积液中CEA及CA153水平可能对肺癌的诊断具有重要的临床意义。

Expression and significance of CEA and CA153 in pleural fluid of patients with lung cancer

Background and objective Finding the cancer cells in pleural fluid of patients with lung can-cer by conventional cytology is always a difficult point. In order to enhance the diagnostic rate of pleural fluid with lung cancer, carcinoembryonic antigen (CEA) and cancer antigen 153 (CA153) were detected in serum and pleural fluid, and their diagnostic values on lung cancer were analyzed. Methods Quantities of CEA and CA153 were detected by chemiluminescence in both serum and pleural fluid of patients with lung cancer (74 cases) and without lung cancer (34 cases). Results The levels of CEA and CA153 in pleural fluid of patients with lung cancer were significantly higher than those without lung cancer (P<0.01). The levels of CEA and CA153 in serum of patients with lung cancer were distinctly higher than those without lung cancer (P<0.01). The levels of CEA and CA153 in pleural fluid were obviously higher than those in serum (P<0.01). The optimal diagnostic assay of lung cancer was CEA+CA153 combination: sensitivity and specificity were 85.1% and 97.1% respectively. Conclusion It could be of important clinical significance for diagnosing lung cancer by assaying CEA and CA153 in pleural fluid of patients with lung cancer.