目的 探索胸腔积液中血管内皮生长因子 (vascular endothelial growth factor,VEGF)、癌胚抗原(carcinoembryonic antigen, CEA)及端粒酶单项和联合检测在良恶性胸腔积液中的诊断价值。方法 选取70例胸腔积液患者,包括恶性胸腔积液34例,良性胸腔积液36例。采用ELISA法检测VEGF和CEA在两组病例胸腔积液中的表达,端粒酶的表达采用PCR-ELISA法检测。结果 VEGF、CEA及端粒酶在恶性胸腔积液患者组中的表达明显高于良性组(P<0.05);在单项检测中,VEGF的敏感性最高73.53%,其阳性预测值最高83.33%;CEA的特异性最高88.88%;联合检测中VEGF+CEA的敏感性最高91.17%,CEA+端粒酶的特异性低于VEGF+CEA和VEGF+端粒酶。结论 VEGF、CEA及端粒酶在良恶性胸腔积液的鉴别诊断中具有较高价值,联合检测可提高诊断的敏感性。

Objective To study the differential diagnosis value of combined measurement of VEGF,CEA and telomerase between benign and malignant pleural effusions . Methods Seventy patients with pleural effusions were observed, including 34 cases of malignant pleural effusions and 36 cases of benign effusions. VEGF and CEA levels in pleural effusion were detected by ELISA.Telomerase activity was tested by PCR-ELISA.Results The expresions of VEGF, CEA and telomerase in the group of patients with malignant pleural effusion were significantly higher than those in the benign group (P<0.05). In single-item detection, the sensitivity and positive predictive values of VEGF were highest (73.53%,83.33%). The specificity of CEA was highest(88.88%). In combined examination, the sensitivity of VEGF+CEA was highest, and the specificity level of CEA+telomerase was lower than that of VEGF+CEA and VEGF+telomerase. Conclusions VEGF, CEA, and telomerase hare high value in the differential diagnosis of benign and malignant pleural effusions. Combined examination can improve the diagnostic sensitivity.