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探讨腺苷脱氨酶（ＡＤＡ）、癌胚抗原（ＣＥＡ）和癌抗原１９－９（ＣＡ１９－９）对老年结核和肿瘤性胸水的鉴别诊断价值。方法检测经病理确诊的≥６０岁的３２例结核性胸膜炎和２０例癌性胸水中的ＡＤＡ、ＣＥＡ和ＣＡ１９－９含量。结果单项检测：ＡＤＡ诊断结核性胸膜炎的敏感性为５７．３％，特异性为９５％，准确度为９５％；ＣＥＡ和ＣＡ１９－９诊断肿瘤性胸水的敏感性分别为６５％和７０％，特异性为８８％和９４％，准确度为７５％和８８％。联合检测：以三项同时符合结核或癌性胸水为诊断依据时，结核和癌性胸水的敏感性分别为５０％和６５％，特异性和准确度均为１００％。结论ＡＤＡ、ＣＥＡ和ＣＡ１９－９联合检测对老年结核与癌性胸水有较高的鉴别诊断价值。
To investigate the differential diagnostic value of adenosine deaminase (ADA), carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9) in senile tuberculosis and tumor pleural effusion. Methods The ADA, CEA and CA19-9 contents in 32 cases of tuberculous pleurisy and 20 cases of cancerous pleural effusion diagnosed by pathology were detected. Results Individual test: The sensitivity, specificity and accuracy of ADA in diagnosing tuberculous pleurisy were 57.3%, 95% and 95%, respectively. The sensitivity of CEA and CA19-9 in diagnosing malignant pleural effusion were 65% and 70%, respectively, Specificity was 88% and 94% with an accuracy of 75% and 88%. Joint detection: The three tuberculosis or cancerous pleural effusion with diagnostic criteria, the sensitivity of tuberculous and cancerous pleural effusion was 50% and 65%, specificity and accuracy were 100%. Conclusion The combined detection of ADA, CEA and CA19-9 has high differential diagnostic value in senile tuberculosis and cancerous pleural effusion.