Clinical Diagnosis Value Of Combinated Detection Of PCT, CRP And CEA For Patients With Pleural Effusion

Objective To investigate the differential diagnosis value of PCT, CRP and CEA united detection in serum and pleural effusion between benign and malignant pleural effusion.Methods Receiver-operating characteristic curve(receive operating characteristc curve,ROC) is used to analyze the results about PCT,CRP and CEA in serum and pleural effusion from40patients with benign pleural effusion(BPE) and34patients with malignant pleural effusion(MPE).The concentration of PCT,CRP a-nd CEA is determined by enzyme-linked immunosorbent assay (ELISA).Results(1) The basic clinical data of patients,white blood cells, neutrophils percentage,and ADA in benign group is higher than malignant(P<0.05), the difference is statistically significant. But age, sex,serum total protein, pleural effusion WBC, pleural effusion single nuclear percentage and TP between the two groups P>0.05, the difference is not statistically significant.(2) PCT in serum has no statistically significant between benign group and malignant group;but in pleural effusion, benign group is higher than malignant group(P<0.05).The difference is statistically significant.In benign group,CRP in benign group is higher than the malignant group(P<0.05);whereas serum, pleural effusion CEA and serum CEA/pleural effusion CEA in malignant group are higher than benign (P<0.05).the difference is statistically significant.(3) Serum PCT. CRP and CEA in the area under the ROC curves are0.865,0.854and0.833, respectively; pleural effusion are0.873,0.836,0.897. The area under the ROC curves of PCT, and CEA in pleural effusion are higher than in serum,but CRP in serum is higher than in pleural effusion. The AUC of serum and pleural effusion PCT are not statistically significant(P>0.05).(4) According to the ROC curves and analysis on Youden's index (YI) maximum, the clinical diagnosis of cut-off value in serum PCT, CRP and CEA are0.23ng/ml,12.17mg/L and6.25ng/ml. In pleural effusion, the clinical diagnosis of cut-off value are0.2ng/ml,9.34mg/Lå'Œ12.54ng/ml。(5) Single detection to differentiate malignant from benign pleural effusion:A CEA in serum, the sensitivity, specific degrees and accuracy rate are82.35%,85%and83.78%, respectively.But in pleural effusion, they are85.29%,87.5%and86.49%, respectively. Pleural effusion CEA diagnostic efficiency is high serum.B The sensitivity of serum PCT, specific degrees and accuracy rate are80%,79.5%and79.73%, respectively; while CRP are65%,85.35%and72.97%, respectively.C The sensitivity of pleural effusion PCT, specific degrees and accuracy rate are85%,76.47%and81.08%, respectively;while CRP are57.5%,82.29%and70.27%.Hence, diagnostic efficiency of PCT in serum and pleural effusion is higher than the CRP.Diagnosis efficiency of CRP in serum is higher than in pleural effusion.(6)The diagnosis efficiency of serum and pleural effusion PCT+CRP are higher than the single detection. Among them, the diagnostic efficiency:pleural effusion PCT+serum CRP is the best.Conclusions1. There is certain value that the measurement of PCT, CRP and CEA concentration in serum and pleural effusion to identify benign and malignant pleural effusion.2. For benign pleural effusion, diagnostic efficiency of PCT in serum and pleural effusion is higher than the CRP.Diagnosis efficiency of CRP in serum is higher than in pleural effusion.For malignant pleural effusion, pleural effusion CEA diagnosis efficiency is higher than serum CEA.3. The diagnosis efficiency of serum and pleural effusion PCT+CRP are higher than the single detection. Among them, the diagnostic efficiency:pleural effusion PCT+serum CRP is the best.