Conejo J R, Benedito J E, Jimenez A, Menchen M, Cano J, Granizo V, Larrodera L
Servicio de Analisis Clinicos, Hospital General Universitario de Guadalajara, Guadalajara, Spain.
Eur J Clin Chem Clin Biochem. 1996 Feb;34(2):139-42.
In order to discriminate between malignant and benign effusions, the values of tissue polypeptide specific antigen,carcinoembryonic antigen and squamous cell carcinoma associated antigen were measured in the pleural fluid of 30 patients with neoplasm, 10 with tuberculous pleurisy, 10 with transudates due to congestive heart failure or cirrhosis, 29 with parapneumonic effusions and 23 with benign diseases other than tuberculosis and pneumonia. Carcinoembryonic antigen and tissue poly-peptide specific antigen levels in effusions due to neoplasms were significantly higher than those in effusions due to other diseases. The areas under Receiver Operating Characteristic curves for carcinoembryonic antigen and tissue polypeptide specific antigen determinations were 0.69 and 0.67, respectively. No significant differences were found in the pleural fluid squamous cell carcinoma associated antigen levels between neoplasms and other diseases. The ability of tissue polypeptide specific antigen and carcinoembryonic antigen to discriminate between benign and malignant effusions may be considered comparable. Although both carcinoembryonic antigen and tissue polypeptide specific antigen showed a low accuracy (the number of undiagnosed pleural effusions is considerably high), both tissue polypeptide specific antigen and carcinoembryonic antigen determinations may contribute to a correct diagnostic classification. Moreover, the combination of these markers provides a specificity of 97.2%. However, the low number of positivities obtained for tissue polypeptide specific antigen and carcinoembryonic antigen together (13 cases in our series) reveals the need for further investigations.
为鉴别恶性和良性胸腔积液，对30例肿瘤患者、10例结核性胸膜炎患者、10例因充血性心力衰竭或肝硬化所致漏出液患者、29例类肺炎性胸腔积液患者以及23例除结核和肺炎以外的良性疾病患者的胸腔积液进行组织多肽特异性抗原、癌胚抗原和鳞状细胞癌相关抗原检测。肿瘤所致胸腔积液中的癌胚抗原和组织多肽特异性抗原水平显著高于其他疾病所致胸腔积液。癌胚抗原和组织多肽特异性抗原检测的受试者工作特征曲线下面积分别为0.69和0.67。肿瘤与其他疾病患者的胸腔积液鳞状细胞癌相关抗原水平无显著差异。组织多肽特异性抗原和癌胚抗原鉴别良性和恶性胸腔积液的能力可认为相当。尽管癌胚抗原和组织多肽特异性抗原的准确性均较低（未诊断出的胸腔积液数量相当多），但组织多肽特异性抗原和癌胚抗原检测均有助于正确的诊断分类。此外，这些标志物联合使用的特异性为97.2%。然而，组织多肽特异性抗原和癌胚抗原同时呈阳性的数量较少（本研究系列中有13例），这表明需要进一步研究。
