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目的:探讨血清和胸水中CA125在结核性和癌性胸水中的表达及鉴别诊断意义。方法:抽选我院确诊的结核性胸水病人85例(结核组)和癌性胸水病人71例(癌症组),检测两组患者血清和胸水中CA125表达,并以胸水/血清中CA125比值>10(p-CA125/s-CA125>10)为临界值,观察其对癌性胸水的鉴别特异度、灵敏度及准确性。结果:癌症组胸水中CA125表达及p-CA125/s-CA125比值均显著高于结核组(P<0.05);但血清中两组CA125表达比较差异无显著性(P>0.05);两组胸水中,以35U/ml为临界值,两组患者阳性率92.9%(79/85)、100%(71/71)比较差异无显著性(X2=7.0718,P=0.0078)。癌症组中p-CA125/sCA125比值>10的比率(84.5%VS 17.6%)明显高于结核组(X2=66.6244,P=0.0000);并以其为诊断癌性胸水的临界值,鉴别诊断特异度、灵敏度及准确性分别为82.3%、84.5%、83.3%。结论:血清和胸水中CA125表达对于鉴别结核性或者是癌性胸水的临床意义不大,但是p-CA125/s-CA125比值对于鉴别结核性和癌性胸水具有一定临床价值。
Objective: To investigate the expression of CA125 in serum and pleural effusion in tuberculous and cancerous pleural effusion and its differential diagnostic significance. Methods: Totally 85 patients with tuberculous pleural effusion diagnosed in our hospital (tuberculosis group) and 71 patients with cancerous pleural effusion (cancer group) were enrolled in this study. CA125 expression in serum and pleural effusion was detected in both groups. The serum CA125 ratio> 10 (p-CA125 / s-CA125> 10) as the critical value to observe the differential specificity, sensitivity and accuracy of cancerous pleural effusion. Results: The expression of CA125 and the ratio of p-CA125 / s-CA125 in pleural fluid of patients with cancer were significantly higher than those of patients with tuberculosis (P <0.05). However, there was no significant difference in serum CA125 between the two groups (P> 0.05) In water, the positive rate was 92.9% (79/85) and 100% (71/71) in the two groups with no significant difference (X2 = 7.0718, P = 0.0078). The ratio of p-CA125 / sCA125> 10 (84.5% vs 17.6%) in the cancer group was significantly higher than that in the tuberculosis group (X2 = 66.6244, P = 0.0000) Degree, sensitivity and accuracy were 82.3%, 84.5% and 83.3% respectively. CONCLUSION: The expression of CA125 in serum and pleural effusion is of little clinical significance for differentiating tuberculous or cancerous pleural effusion. However, the ratio of p-CA125 / s-CA125 is of clinical value in differentiating tuberculous and cancerous pleural effusion.