Liu Yunqiu, Yu Liqun, Lin Jiangtao
Department of Respiratory Diseases, Affiliated Kailuan Hospital, Huabei Coal Medical School, Tangshan, Hebei 063000, P.R.China.
Zhongguo Fei Ai Za Zhi. 2006 Jun 20;9(3):273-6. doi: 10.3779/j.issn.1009-3419.2006.03.14.
Malignant pleural effusion is usually caused by lung cancer, and tumor markers may be helpful to its differential diagnosis. The aim of this study is to explore the clinical value of serum and pleural effusion pro-gastrin-releasing peptide (ProGRP), neuron specific enolase (NSE), cyto- keratin fragment 19 (CYFRA21-1) and carcinoembryonic antigen (CEA) in differential diagnosis and histological typing of malignant pleural effusion caused by lung cancer.
According to histological type of primary tumor, 99 patients with malignant pleural effusion caused by lung cancer were divided into small cell lung cancer (SCLC) group, adenocarcinoma group and squamous cell carcinoma group, with 37 patients with benign pleural effusion and 35 healthy persons as controls. Diagnostic value of serum and pleural effusion ProGRP , NSE, CYFRA21-1 and CEA was evaluated for each group.
The levels of ProGRP, NSE, CYFRA21-1 and CEA in serum and pleural effusion of all the malignant groups were significantly higher than those in the control groups (P < 0.01). In the SCLC group, detection of pleural effusion ProGRP showed the highest Youden index and accuracy. In the adenocarcinoma group and squamous cell carcinoma group, combined detection of pleural effusion CEA+CYFRA21-1 (on parallel test) showed the highest Youden index and accuracy.
Detection of pleural effusion tumor markers ProGRP, CYFRA21-1, NSE and CEA is of great clinical value in differential diagnosis and histological typing of malignant pleural effusion. Pleural effusion ProGRP is the optimal tumor marker for malignant pleural effusion caused by SCLC. Pleural effusion CEA+CYFRA21-1 (on parallel test) is a good auxiliary diagnosis index for malignant pleural effusion caused by adenocarcinoma and squamous cell carcinoma of the lung.
恶性胸腔积液通常由肺癌引起，肿瘤标志物可能有助于其鉴别诊断。本研究旨在探讨血清和胸腔积液中胃泌素释放肽前体（ProGRP）、神经元特异性烯醇化酶（NSE）、细胞角蛋白片段19（CYFRA21-1）和癌胚抗原（CEA）在肺癌所致恶性胸腔积液鉴别诊断及组织学分型中的临床价值。
根据原发性肿瘤的组织学类型，将99例肺癌所致恶性胸腔积液患者分为小细胞肺癌（SCLC）组、腺癌组和鳞癌组，以37例良性胸腔积液患者和35例健康人为对照。评估血清和胸腔积液中ProGRP、NSE、CYFRA21-1和CEA对各组的诊断价值。
所有恶性组血清和胸腔积液中ProGRP、NSE、CYFRA21-1和CEA水平均显著高于对照组（P<0.01）。在SCLC组中，检测胸腔积液ProGRP的约登指数和准确率最高。在腺癌组和鳞癌组中，联合检测胸腔积液CEA+CYFRA21-1（平行试验）的约登指数和准确率最高。
检测胸腔积液肿瘤标志物ProGRP、CYFRA21-1、NSE和CEA在恶性胸腔积液的鉴别诊断及组织学分型中具有重要临床价值。胸腔积液ProGRP是SCLC所致恶性胸腔积液的最佳肿瘤标志物。胸腔积液CEA+CYFRA21-1（平行试验）是肺腺癌和鳞癌所致恶性胸腔积液的良好辅助诊断指标。
