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目的探讨联合检测血清、浆膜腔积液多项肿瘤标志物对浆膜腔积液性质的诊断价值。方法应用放免法分别检测血清、浆膜腔积液中ＡＦＰ、ＣＥＡ、ＣＡ１２５、ＣＡ５０、ＣＡ１９－９及计算浆膜腔积液／血清（ｄ／ｓ）值。共检测７１例，分为恶性积液、恶性肿瘤伴良性积液、结核性积液、非结核性良性疾病伴积液四组。结果ＣＡ１２５在结核组与恶性积液组血清、积液中均有较高的阳性率。积液中ＡＦＰ、ＣＥＡ、ＣＡ５０、ＣＡ１９－９至少一项以上阳性并ｄ／ｓ值＞１．５，恶性积液诊断率达９８５％。积液中ＡＦＰ、ＣＥＡ、ＣＡ５０、ＣＡ１９－９中至少一项以上阳性并ｄ／ｓ值＜０．６７，恶性肿瘤伴良性积液诊断率９８３％。积液中ＣＡ１２５阳性并ｄ／ｓ值＞１．５而ＡＦＰ、ＣＥＡ、ＣＡ５０、ＣＡ１９－９均阴性诊断结核性浆膜腔积液诊断率１００％。结论联合检测血清、浆膜腔积液中的ＡＦＰ、ＣＥＡ、ＣＡ５０、ＣＡ１９－９、ＣＡ１２５及计算其ｄ／ｓ值，对恶性积液、恶性肿瘤伴良性积液及结核性积液的鉴别诊断有重要临床价值。
Objective To investigate the diagnostic value of combined detection of multiple tumor markers in serum and serous effusions for serous effusions. Methods Radioimmunoassay was used to detect AFP, CEA, CA125, CA50, and CA19-9 in serum and serous effusions, and the plasma effusion/serum (d/s) values were calculated. A total of 71 cases were divided into four groups: malignant effusion, malignant tumor with benign effusion, tuberculous effusion, and non-tuberculous benign disease with effusion. Results CA125 had a high positive rate in the serum and effusion of tuberculosis group and malignant effusion group. The effusions were positive for at least one of AFP, CEA, CA50, and CA19-9 with a d/s value of >1.5, and the malignant effusion diagnosis rate was 98.5%. At least one of the AFP, CEA, CA50, and CA19-9 in the effusion was positive and the d/s value was less than 0.67. The diagnosis rate of malignant tumor with benign effusion was 98. 3%. Accumulation of CA125 positive and d/s value> 1.5 and AFP, CEA, CA50, CA19-9 were negative diagnosis of tuberculous effusion effusion diagnosis rate of 100%. Conclusion The combined detection of AFP, CEA, CA50, CA19-9, CA125 in serum and serous cavity effusions and the calculation of their d/s value, the differential diagnosis of malignant effusion, malignant tumor with benign effusion and tuberculous effusion Has important clinical value.