YKL-40和CEA在恶性胸腔积液诊断中的应用价值

发布时间：2018-08-24 09:48

【摘要】：目的:探讨胸水YKL-40和CEA联合检测在恶性胸腔积液诊断中的应用价值方法:入选我院2013年11月至2014年11月间呼吸内科及肿瘤内科收治胸腔积液患者97例,其中,BPE45例,男21例,女24例,年龄35~78岁,平均52.8岁;MPE患者52例,男29例,女23例,年龄39~80岁,平均58.3岁。45例良性胸腔积液中结核性33例,肺炎旁积液6例,低蛋白血症4例,心力衰竭2例。52例MPE均源于原发性支气管肺癌,其中,腺癌36例,鳞癌5例,小细胞型肺癌4例,其他不能明确病理分型的7例。有淋巴结转移者35例,无淋巴结转移者17例,均常规抽取胸腔积液分别采用酶联免疫吸附实验法(ELISA)检测YKL-40、电化学发光法(ECLIA)检测CEA,用统计学软件SSPS15进行数据分析,P0.05有统计学意义。结果:MPE组胸水YKL-40和CEA含量均高于BPE组(P0.05);不同肿瘤类型、有无淋巴结转移的患者间胸水YKL-40水平差异显著(P0.05),而YKL-40与性别、年龄、肿瘤分化程度无关(P0.05);胸水CEA升高与肿瘤病理类型有关(P0.05),而在其他临床特点间无明显差异(P0.05);CEA诊断灵敏度和特异度均高于YKL-40,两组间差异显著,具有统计学意义(P0.05);当YKL-40联合CEA时,灵敏度和特异度得到进一步提高,优于YKL-40和CEA单独运用于MPE的诊断(P0.05)。结论:MPE组中YKL-40含量较BPE组明显增高,YKL-40检测对于MPE的诊断有一定的价值,有望成为BPE、MPE鉴别诊断的一种指标,其在诊断MPE时的灵敏度和特异度相对低于CEA,但YKL-40和CEA联合检测可显著提高对MPE诊断的灵敏度和特异度。
[Abstract]:Objective: to investigate the value of combined detection of YKL-40 and CEA in the diagnosis of malignant pleural effusion. Methods: 97 cases of pleural effusion were selected in our hospital from November 2013 to November 2014. 24 women, aged 35 to 78 years, with an average of 52.8 years old, 52 patients with MPE, 29 males and 23 females, age 3980 years, mean 58.3 years old, 45 cases of benign pleural effusion, 33 cases of tuberculous pleural effusion, 6 cases of parapneumonic effusion, 4 cases of hypoproteinemia, 3 cases of tuberculous pleural effusion, 6 cases of parapneumonic effusion and 4 cases of hypoproteinemia. Two patients with heart failure and 52 patients with MPE originated from primary bronchial lung cancer, including 36 cases of adenocarcinoma, 5 cases of squamous cell carcinoma, 4 cases of small cell lung cancer, and 7 cases of other cases whose pathological classification could not be determined. There were 35 cases with lymph node metastasis and 17 cases with no lymph node metastasis. Routine pleural effusion was extracted by enzyme linked immunosorbent assay (ELISA) to detect YKL-40, electrochemiluminescence (ECLIA) and CEA, (P 0.05). Results the levels of YKL-40 and CEA in pleural effusion were higher than those in BPE group (P0.05), the levels of YKL-40 in pleural effusion with or without lymph node metastasis were significantly different among patients with different tumor types (P0.05). The degree of tumor differentiation was not significant (P0.05), the increase of CEA in pleural effusion was related to the pathological type of tumor (P0.05), but there was no significant difference between other clinical features (P0.05). The diagnostic sensitivity and specificity of YKL-40, were significantly higher than those of YKL-40, (P0.05); when YKL-40 combined with CEA, there was a significant difference between the two groups (P0.05). The sensitivity and specificity were further improved, which was better than that of YKL-40 and CEA alone in the diagnosis of MPE (P0.05). Conclusion the content of YKL-40 in the YKL-40 group is significantly higher than that in the BPE group. The detection of YKL-40 is valuable for the diagnosis of MPE, and it is expected to be an index for differential diagnosis of BPE,MPE. The sensitivity and specificity of YKL-40 and CEA in the diagnosis of MPE were lower than those in CEA, but the combined detection of YKL-40 and CEA could significantly improve the sensitivity and specificity of MPE diagnosis.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.43

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