Diagnostic Value Of Combined Determination Of Serum And Pleural Effusion CEA, CYFRA21-land NSE Levels And Lung Biopsy In Patients With Malignancy

Objective Objective To study the clinical value of combined determination of serum and pleural effusion levels of CEA, CY-FRA21-1 , NSE and Lung biopsy in patients with malignancyMethods Selected in our hospital in September 2008 ~ December 2010 hospitalized patients. 43 patients with malignant pleural effusion, age 40 to 79 years old. Where (adenocarcinoma 27 cases, 12 cases of squamous cell carcinoma, small cell carcinoma in 10 cases) were diagnosed by fiberoptic bronchoscopy. 40 patients with benign pleural plot, aged 20 to 74 years old. Which tuberculous exudative pleurisy in 21 cases, 7 cases of cardiac insufficiency, inflammatory pleurisy in 12 cases combined, are classic clinical manifestations, imaging, laboratory tests and bronchoscopy-related and other diagnosis. Also selected 20 cases of healthy volunteers as normal control group. The above group sex, age, basic match. Detected by electrochemiluminescence, 49 cases of malignant pleural effusion (malignant group) and 40 patients with benign pleural effusion, healthy volunteers serum and pleural effusion CEA, CYFRA21-1 and NSE levels. Lung biopsy specimens of paraffin sections for HE staining pathological diagnosis.Results 1. CEA (ng / mL) levels compared to normal control group and benign pleural effusion in the serum level was significantly lower than that of malignant pleural effusion group [(2.46±1.16) ng / ml, (3.17±1.18) ng / ml vs ( 8.89±3.98) ng / ml, (16.14±6.80) ng / ml, (8.23±3.54) ng / ml, both P <0.01)]; benign pleural effusion pleural effusion group was significantly lower than that of malignant pleural effusion group [(3.06±0.89) ng / ml vs (16.15±8.02) ng / ml, (22.55±8.79) ng / ml (13.57±8.01) ng / ml P <0.01)]2. NSE (ng / mL) levels compared to normal control group and benign pleural effusion in the serum level was significantly lower than that of malignant pleural effusion group [(5.02±3.13) ng / ml, (8.98±5.21) ng / ml vs ( 40.08±18.12) ng / ml, (18.54±11.93) ng / ml, (19.31±9.87) ng / ml, both P <0.01)]; benign pleural effusion pleural effusion group was significantly lower than that of malignant pleural effusion group [(8.85±3.50) ng / ml vs (59.43±19.80) ng / ml, (31.25±15.89) ng / ml (35.61±17.31) ng / ml P <0.01)]3. CYFRA21-1 (ng / mL) levels compared to normal control group and benign pleural effusion in the serum level was significantly lower than that of malignant pleural effusion group [(1.58±0.65) ng / ml, (1.47±0.78) ng / ml vs (4.96±1.76) ng / ml, (4.53±2.10) ng / ml, (10.24±3.12) ng / ml, both P <0.01)]; benign pleural effusion pleural effusion group was significantly lower than that of malignant pleural effusion group [(2.29±0.67) ng / ml vs (7.14±2.85) ng / ml, (7.68±2.90) ng / ml (16.78±5.12) ng / ml P <0.01)]4. Different pathological types of lung cancer and pleural effusion of blood tumor markers in the diagnosis of three relatively①sensitivity of NSE was significantly higher than that of small cell lung adenocarcinoma, lung squamous cell carcinoma group (61.8% vs 18.1%, P <0.01), OR the value is; (61.8% vs 21.1%, P <0.01).②CEA was higher than that of lung cancer small cell lung cancer squamous cell carcinoma group (54.6% vs 24.5%, P <0.05); (54.6% vs 28.9%, P <0.05).③CYFRA21-1 squamous cell carcinoma was significantly higher than that of small cell lung cancer, lung cancer group (59.6% vs 29.4%, P <0.05); (59.6% vs 21.7%, P <0.05).5. Three Tumor Markers detection sensitivity compared with single pleural effusion①Three Markers compared with individual tumor markers. (92.1% vs 79.7%, 36.1%, 44.2%, P <0.01). (92.9% vs 43.9%, 79.7%, 49.5%, P <0.01). (87.2% vs 41.6%, 34.8%, 74.2%, P <0.01).②The serum markers combined detection of three tumor markers in comparison with the single. (83.9% vs 24.5%, 29.4%, 61.8%, P <0.01). (84.3% vs 54.6%, 21.7%, 18,1%, P <0.01). (82.8% vs 28.9%, 21.2%, 59.6%, P <0.01).6. Lung biopsy in the diagnosis of malignant small cell carcinoma of the sensitivity of 100%; lung cancer 96%; 91% of lung squamous cell carcinoma.Conclusion 1. Malignant pleural effusion, and pleural effusion of serum CEA, NSE and CYFRA21-1 was significantly higher than the normal control group and benign pleural effusion group (P <0.05). 2. Malignant pleural effusion were CEA, NSE and CYFRA21-1 pleural effusion was significantly higher than serum levels (P <0.05). 3. Lung cancer CEA, small cell lung cancer NSE, squamous cell carcinoma of CYFRA21-1 levels in serum and pleural effusion were higher than in other pathological types of lung cancer (P <0.01), 4. Malignant pleural effusion CEA, NSE and CYFRA21 -1 single test diagnostic sensitivity was significantly higher than in serum (P <0.05), CEA in lung cancer, NSE in small cell lung cancer, CYFRA21-1 on pulmonary diagnostic sensitivity scales were significantly higher than other single tumor markers (P <0.05 ); 5.CEA + NSE + CYFRA21-1 combined diagnostic sensitivity than single tumor markers Ming (P <0.05), 6. CEA, CYFRA21-1 and NSE index JIU than a single test can significantly improve the diagnosis of malignant pleural effusion sensitivity of a purpose to help find the cause of clinical, diagnosis of malignant pleural effusion has high clinical value. 7. Lung biopsy can significantly improve lung cancer diagnosis of pleural effusion positive rate, should be widely applied.