Dialanostic utility of serum and pleural fluid carcinoembryonic antigen, neuron-specific enolase, and cytokeratin 19 fragments in patients with effusions from primary lung cancer
Dialanostic utility of serum and pleural fluid carcinoembryonic antigen, neuron-specific enolase, and cytokeratin 19 fragments in patients with effusions from primary lung cancer
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DOI：
10.1378/chest.128.4.2298
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发表时间：
2005-10-01
期刊：
影响因子：
9.6
通讯作者：
Chang, JH
中科院分区：
文献类型：
--
作者：
Lee, JH;Chang, JH
研究目的：探讨癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和细胞角蛋白19片段在乳腺癌诊断中的价值（CYFRA 21-1）作为原发性肺癌胸膜炎的标志物。设计：前瞻性病例对照研究。设置：一所三级大学医院。患者：34名肺癌患者和16名结核性胸膜炎患者。测量和结果：采用免疫分析法检测肺癌和结核性胸膜炎患者血清和胸水中CEA、NSE和CYFRA 21-1的水平。发现肺癌患者的血清和胸腔液CEA和CYFRA 21-1水平显著高于结核性胸膜炎患者。分别使用血清CEA、NSE和CYFRA 21-1的5 ng/mL、20 ng/mL和3.3 ng/mL的截止值，这些肿瘤标志物区分恶性积液和良性积液的灵敏度和特异性如下：CEA，68%和93%; NSE，34%和93%; CYFRA 21-1，45%和100%。使用5 ng/mL、20 ng/mL和45 ng/mL的胸水截止值，灵敏度和特异性如下：CEA，82%和94%; NSE，36%和94%; CYFRA 21-1，61%和81%。结论：在诊断肺癌相关恶性胸腔积液时，胸水中CEA和NSE的检测比三种肿瘤标志物的检测更能提高诊断率。
Study objectives: To assess the diagnostic values of carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragments (CYFRA 21-1) as markers of pleurisy in primary lung cancer.Design: Prospective case-control study.Setting: A tertiary university hospital.Patients: Thirty-four patients with lung cancer and 16 patients with tuberculous pleurisy.Measurements and results: Levels of CEA, NSE, and CYFRA 21-1 were measured by immunoassay in the serum and pleural fluid of patients with lung cancer and of patients with tuberculous pleurisy. Patients with lung cancer were found to have significantly higher serum and pleural fluid levels of CEA and CYFRA 21-1 than patients with tuberculous pleurisy. Using cutoff values of 5 ng/mL, 20 ng/mL, and 3.3 ng/mL for serum CEA, NSE, and CYFRA 21-1, respectively, the sensitivities and specificities of these tumor markers were as follows for differentiating malignant effusion from benign: CEA, 68% and 93%; NSE, 34% and 93%; and CYFRA 21-1, 45% and 100%. Using cutoff values of 5 ng/mL, 20 ng/mL, and 45 ng/mL for pleural fluid, the sensitivities and specificities were as follows: CEA, 82% and 94%; NSE, 36% and 94%; and CYFRA 21-1, 61% and 81%. A combination of pleural fluid CEA and NSE increased sensitivity and specificity.Conclusions: In the diagnosis of malignant effusion associated with lung cancer, the determinations of CEA and NSE in pleural fluid could enhance diagnostic yield better than those of all three tumor markers.