脱落细胞学及胸腔积液肿瘤标志物在肺癌伴胸腔积液患者中的表达及临床意义

摘要/Abstract

摘要： 目的探讨肺癌伴胸腔积液患者中脱落细胞学及胸腔积液肿瘤标志物的表达情况及其临床意义,为恶性肿瘤的诊断提供依据。方法选取2018年6月—2023年6月泰安市肿瘤防治院收治的肺肿瘤伴胸腔积液的90例患者作为研究对象。所有患者均行脱落细胞检查及癌胚抗原（Carcinoembryonic Antigen,CEA）、糖类抗原125（Carbohydrate Antigen 125,CA125）、糖类抗原19-9（Carbohydrate Antigen 19-9,CA19-9）、神经元特异性烯醇化酶（Neuron Specific Enolase,NSE）等标志物检查。按照手术或取活检行病理学检查金标准将90例患者分为肺良性肿瘤组48例和肺癌组42例。比较两组患者脱落细胞学检出情况、肿瘤标志物水平及阳性表达率。ROC曲线比较胸腔积液脱落细胞学检查、肿瘤标志物及联合检测对恶性胸腔积液的诊断效能。结果肺癌组胸腔积液CEA、CA19-9、NSE、CA125水平明显高于肺良性肿瘤组,差异有统计学意义（P<0.05）。90 例肿瘤伴胸腔积液患者均接受胸腔积液脱落细胞学检查,其中,42例肺癌患者检查到肿瘤细胞32例（76.19%）,22例经1次送检确诊,10例经两次或以上送检确诊,其余10例未检查到肿瘤细胞。联合检测诊断价值最高（曲线下面积0.889）,肿瘤标志物检测诊断价值最低（曲线下面积0.767）,脱落细胞学检测诊断价值仅次于联合检测（曲线下面积0.881）,差异有统计学意义（P<0.05）。结论脱落细胞学联合胸腔积液肿瘤标志物更有利于肺癌伴胸腔积液患者的诊断。

关键词: 肺癌, 脱落细胞学, 胸腔积液, 肿瘤标志物

Abstract: Objective To investigate the expression of cytological examination and tumor markers in patients with lung cancer accompanied by pleural effusion, and their clinical significance, to provide a basis for the diagnosis of malignant tumors. Methods A total of 90 patients with lung tumors accompanied by pleural effusion who were treated at Taian Cancer Prevention and Treatment Hospital from June 2018 to June 2023 were selected for this study. All patients underwent cytological examination and tests for carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), and neuron-specific enolase (NSE). According to the gold standard of pathological examination through surgery or biopsy, the 90 patients were divided into a benign lung tumor group(48 cases) and a lung cancer group (42 cases). The cytological detection rates, levels of tumor markers, and positive expression rates were compared between the two groups. The diagnostic efficacy of cytological examination of pleural effusion,tumor markers, and combined detection for malignant pleural effusion was compared using ROC curves. Results In the lung cancer group, the levels of CEA, CA19-9, NSE, and CA125 in pleural effusion were significantly higher than those in the benign lung tumor group,and the difference was statistically significant (P<0.05). All 90 patients with tumor-associated pleural effusion underwent cytological examination; among the lung cancer patients, tumor cells were detected in 32 out of 42 cases (76.19%), with 22 diagnosed upon the first submission and 10 diagnosed after two or more submissions, while the remaining 10 cases did not show tumor cells. No tumor cells were detected in the 48 patients with benign lesions. The combined detection showed the highest diagnostic value (area under the curve [AUC]=0.889), followed by tumor marker detection (AUC=0.767) and cytological detection (AUC=0.881)(P<0.05). Conclusion The combination of cytological examination and tumor markers in pleural effusion is more beneficial for the diagnosis of patients with lung cancer accompanied by pleural effusion.

Key words: lung cancer, cytological examination, pleural effusion, tumor markers

中图分类号:

R730.4

丁蔷薇, 张士才. 脱落细胞学及胸腔积液肿瘤标志物在肺癌伴胸腔积液患者中的表达及临床意义[J]. 中华养生保健, 2025, 43(9): 193-196.

DING Qiang-wei, ZHANG Shi-cai. Expression and Clinical Significance of Exfoliative Cytology and Pleural Effusion Tumor Markers in Lung Cancer Patients with Pleural Effusion[J]. ZHONGHUA YANGSHENG BAOJIAN, 2025, 43(9): 193-196.

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