【摘要】：目的探討改良胸膜活檢術(shù)聯(lián)合生物標(biāo)志物、細(xì)胞學(xué)檢查在不明原因胸腔積液中的診斷價(jià)值。方法對(duì)216例胸腔積液患者的臨床資料進(jìn)行回顧性分析,其中結(jié)核性胸腔積液(結(jié)核組)106例,惡性胸腔積液110例(惡性組)。所有患者均行改良胸膜活檢術(shù)檢查,胸腔積液細(xì)胞學(xué)檢查,胸腔積液腺苷脫氨酶(ADA)、癌胚抗原(CEA)及乳酸脫氫酶(LDH)檢測(cè)以及血CEA檢測(cè)。統(tǒng)計(jì)胸膜活檢術(shù)的確診率,比較兩組胸腔積液的ADA、CEA、LDH以及血CEA、胸腔積液CEA/血CEA水平。結(jié)果 216例患者共進(jìn)行了241次胸膜活檢穿刺,首次穿刺取材成功率94.9%(205/216),首次穿刺成功的胸膜活檢材料病理結(jié)果有診斷價(jià)值的占58.8%(127/216),總確診率65.3%(141/216),不良反應(yīng)發(fā)生率為5.8%(14/241)。結(jié)核組細(xì)胞學(xué)檢查腫瘤細(xì)胞陽(yáng)性0例,惡性組細(xì)胞學(xué)檢查腫瘤細(xì)胞陽(yáng)性率54.5%(60/110);惡性組中胸腔積液CEA、LDH、血CEA及胸腔積液CEA/血CEA水平及陽(yáng)性率均顯著高于結(jié)核組,而胸腔積液ADA水平以及陽(yáng)性率顯著低于結(jié)核組,差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論改良胸膜活檢術(shù)、胸腔積液細(xì)胞學(xué)、胸腔積液生物標(biāo)志物在單獨(dú)輔助診斷胸腔積液時(shí)均具有一定的局限性,臨床上可聯(lián)合多種指標(biāo)明確胸腔積液病因,指導(dǎo)治療。
[Abstract]:Objective to evaluate the diagnostic value of modified pleural biopsy combined with biomarkers and cytology in pleural effusion of unknown origin. Methods the clinical data of 216 cases of pleural effusion were analyzed retrospectively, including 106 cases of tuberculous pleural effusion (tuberculosis group) and 110 cases of malignant pleural effusion (malignant group). All patients were examined by modified pleural biopsy, pleural effusion cytology, adenosine deaminase (ADA), carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH) and serum CEA. The diagnostic rate of pleural biopsy was analyzed and the levels of ADAA CEA LDH blood CEA and CEA / CEA in pleural effusion were compared between the two groups. Results 241 pleural biopsies were performed in 216 patients. The successful rate of the first puncture was 94.9% (205 / 216). The diagnostic value of the first successful pleural biopsy materials was 58.8% (127 / 216). The total diagnosis rate was 65.3% (141216), and the incidence of adverse reactions was 5.8% (14 / 241). The positive rate of tumor cells was 54.5% (60 / 110) in malignant group, LDH in pleural effusion, CEA in serum and CEA / CEA / CEA in pleural effusion in malignant group were significantly higher than those in tuberculosis group. The level and positive rate of ADA in pleural effusion were significantly lower than that in tuberculosis group (P0.01). Conclusion improved pleural biopsy, pleural effusion cytology and pleural effusion biomarkers have some limitations in the diagnosis of pleural effusion alone.
【作者單位】： 四川省廣安市人民醫(yī)院檢驗(yàn)科;四川省廣安市人民醫(yī)院胸外科;
【分類號(hào)】：R561.3

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本文編號(hào)：2131171