Li Hongmei, Fu Junhua, Xiu Yuande, Zhou Qinghua
Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhongguo Fei Ai Za Zhi. 2010 Jun;13(6):652-4. doi: 10.3779/j.issn.1009-3419.2010.06.017.
BACKGROUND AND OBJECTIVE Telomerase and CYFRA21-1 may be positively expressed in malignant pleural effusion, but the sensitivity and specificity of single tumor marker were low. The aim of this study is to investigate the diagnostic value of combining determination of telomerase activity and CYFRA21-1 levels in differentiating benign from malignant pleural effusion caused by lung cancer.
80 patients with malignant and 50 patients with benign pleural effusion were enrolled into this study. The telomerase activity in pleural effusion was tested by means of telomeric repeat amplification protocal-PCR-ELISA (TRAP-PCR-ELISA) and CYFRA21-1 levels were tested by the EIA method. All the results were analyzed by the statistical method.
The levels of telomerase and CYFRA21-1 in malignant pleural effusion was significantly higher than that in benign one (t = 17.252 and t = 13.951, P < 0.001). The sensitivity of telomerase activity testing for diagnosing malignant pleural effusion was 71.3%; the specificity was 86.0% and the overall accuracy was 76.9%. The sensitivity of CYFRA 21-1 testing was 60.0%, the specificity was 78.0% and the overall accuracy was 66.9%. The sensitivity of the combined testing was 90.0%, the specificity was 76.0% and the overall accuracy was 86.9%. The sensitivity and the overall accuracy of combined testing were higher than those of telomerase and CYFRA21-1 testing single (chi2 = 9.002 and chi2 = 19.201, P < 0.01; chi2 = 4.389 and chi2 = 14.647, P < 0.05).
The combined testing oftelomerase with CYFRA21-1 can increase the sensitivity and overall accuracy of differential diagnosis of benign and malignant pleural effusion diagnosis.
背景与目的 端粒酶和细胞角蛋白19片段(CYFRA21-1)在恶性胸腔积液中可能呈阳性表达,但单一肿瘤标志物的敏感性和特异性较低。本研究旨在探讨联合检测端粒酶活性和CYFRA21-1水平在鉴别肺癌所致良性与恶性胸腔积液中的诊断价值。
本研究纳入80例恶性胸腔积液患者和50例良性胸腔积液患者。采用端粒重复序列扩增法-聚合酶链反应-酶联免疫吸附测定(TRAP-PCR-ELISA)检测胸腔积液中端粒酶活性,采用酶免疫分析法检测CYFRA21-1水平。所有结果采用统计学方法分析。
恶性胸腔积液中端粒酶和CYFRA21-1水平显著高于良性胸腔积液(t = 17.252,t = 13.951,P < 0.001)。端粒酶活性检测诊断恶性胸腔积液的敏感性为71.3%;特异性为86.0%,总准确率为76.9%。CYFRA21-1检测的敏感性为60.0%,特异性为78.0%,总准确率为66.9%。联合检测的敏感性为90.0%,特异性为76.0%,总准确率为86.9%。联合检测的敏感性和总准确率高于端粒酶和CYFRA21-1单项检测(χ2 = 9.002,χ2 = 19.201,P < 0.01;χ2 = 4.389,χ2 = 14.647,P < 0.05)。
端粒酶与CYFRA21-1联合检测可提高良性与恶性胸腔积液鉴别诊断的敏感性和总准确率。