Regression Analysis The Predictive Value Of Combined Detection Of Multiple Tumor Markers In Diagnosis For Malignant Pleural Effusions

Objective: To evaluate contents of six tumor markers CEA, TPA, SCC, CYFRA21-1, NSE, CA15-3 in serum or pleural effusion. And to study the role of co-detections of the six tumor makers for differential diagnosis of benign and malignant pleural effusions. To evaluate the predictive value of combined assay of these six tumor makers .Methods: The serum and pleural fluid of 40 patients , the serum of 5 health people were collected . The levels of CEA , TPA , SCC , CYFRA21-1, NSE, CA15-3 in serum and pleural effusion were detected by ELISA and chemiluminescence, the sensitivity,the specificity and the positive predictive value of tumor markers combined assay were counted.Results: The serum levels of CYFRA21-1, NSE, CEA, SCC, CA153 and TPA in health persons were in normal. The serum levels of CEA, CYFRA21-1, TPA in patients with malignant pleural effusion were significantly higher than those patients with benign pleural effusion and the health persons (P<0.05). The pleural effusion levels of CEA, SCC, CYFRA21-1 in patients with malignant pleural effusion were higher than those patients with benign pleural effusion (P<0.05). There was significantly difference between serum and pleural fluid levels of CEA, SCC, CYFRA21-1 in patients with malignant pleural effusion (P<0.05). when combined test CEA+ CYFRA21-1 in pleural effusion (the parallel test), the sensitivity, specificity and the positive predictive value were 82.6%, 82.4% and 86.4%, the sensitivity has increased significantly compared with single tumor marker detection. Meanwhile, the sensitivity has increased with more tumor makers included,but specificity has declined. Combined CEA+CYFRA21-1 (the series test) in pleural effusion, the specificity, positive predictive value both were 100.0%. Logistic regression analysis showed that, it can increased the forecast accuracy rate (82.5%) of differential diagnosis of benign and malignant pleural effusion by combined test CEA, CYFRA21-1.Conclusions: (1) These six tumor markers have different clinical application of differential diagnosis of benign and malignant pleural effusions. And CEA, NSE, SCC, CYFRA21-1, in which the significance of detection in pleural effusion level greater than in serum level. (2) The combined determination of the six tumor markers can increase the sensitivity and the specificity in the differential diagnosis of benign and malignant pleural effusion. CEA+CYFRA21-1 was the best combination.