CYFRA21-1、MMP-3及CEA 和细胞学联合检查对恶性胸腔积液的诊断价值分析

摘要 目的：探讨细胞角蛋白19片段（CYFRA21-1）、基质金属蛋白酶-3（MMP-3）及癌胚抗原（CEA） 和细胞学联合检查对恶性胸腔积液的诊断价值。方法：选择2020年1月至2023年1月我院接诊的100例胸腔积液患者进行研究，并根据病理结果分为实验组47例（病理检查结果恶性），对照组53例（病理检查结果良性），分析血清CYFRA21-1、MMP-3及CEA 和细胞学水平变化情况及其的诊断价值。结果：实验组患者血清血清CYFRA21-1、MMP-3及CEA水平显著高于对照组，差异显著（P＜0.05）；实验组患者CYFRA21-1、MMP-3及CEA 和细胞学阳性率均显著高于对照组，差异显著（P＜0.05）；CYFRA21-1诊断恶性胸腔积液的AUC为0.989，95%CI为0.977~1.000；MMP-3诊断恶性胸腔积液的AUC为0.979，95%CI为0.964~0.994；CEA 诊断恶性胸腔积液的AUC为0.982，95%CI为0.967~0.997；细胞学诊断恶性胸腔积液的AUC为0.823，95%CI为0.766~0.879，联合检测时AUC为0.995，95%CI为0.990~1.000，较单独检测曲线下面积比较显著差异；且特异度、准确度均较单独检测更高。结论：CYFRA21-1、MMP-3及CEA 和细胞学联合检查可有效提高诊断恶性胸腔积液的准确性，临床应用价值高。

Diagnostic Value of CYFRA21-1, MMP-3 and CEA Combined with Cytology in Malignant Pleural Effusion

ABSTRACT Objective: To study Diagnostic value of Cytokeratin 19 fragment (CYFRA21-1), matrix metalloproteinase-3 (MMP-3) and carcinoembryonic antigen (CEA) combined with cytology in malignant pleural effusion. Methods: 100 patients with pleural effusion admitted to our hospital from January 2020 to January 2023 were selected for study, and were divided into experimental group (47 cases with malignant pathological examination results) and control group (53 cases with benign pathological examination results) according to pathological findings. The changes of serum CYFRA21-1, MMP-3, CEA and cytology levels and their diagnostic value were analyzed. Results: The serum levels of CYFRA21-1, MMP-3 and CEA in experimental group were significantly higher than those in control group (P<0.05). The positive rates of CYFRA21-1, MMP-3, CEA and cytology in experimental group were significantly higher than those in control group (P<0.05). The AUC of CYFRA21-1 in the diagnosis of malignant pleural effusion was 0.989, 95%CI was 0.977~1.000. The AUC and 95%CI of MMP-3 in the diagnosis of malignant pleural effusion were 0.979 and 0.964-0.994. The AUC for CEA diagnosis of malignant pleural effusion was 0.982, 95%CI was 0.967~0.997. The AUC and 95%CI for the diagnosis of malignant pleural effusion were 0.823, 0.766~0.879, and the AUC and 95%CI for combined detection were 0.995 and 0.990~1.000, which were significantly different from the area under the curve for single detection. The specificity and accuracy are higher than that of single detection. Conclusion: CYFRA21-1, MMP-3 and CEA combined with cytology can effectively improve the accuracy of diagnosis of malignant pleural effusion, and have high clinical application value.