Value of medical thoracoscope and the level of carcinoembryonic antigen in the body to diagnosis malignant pleural effusion

Objective To disscuss the value of medical thoracoscopy in the diagnosis of malignant pleural effusion and probe the clinical significance of the diagnosis of malignant pleural effusion of the level of carcinoembryonic antigen (carcino-embryonic antigen, CEA) in pleural fluid, serum. Methods We analyzed retrospective the clinical data of 77 patients with pleural effusion during August 2015 to August 2016.We took the medical thoracoscope pathological results as the gold standard and evaluated the value of the level of CEA in pleural effusion and in serum and the pleural effusion/serum CEA ratio to diagnosis malignant pleural effusion. Results ①Among the 77 patients with pleural effusion, medical thoracoscope could clearly diagnosis 74 of them (46 of them were with malignant pleural effusion, 27 of them were with tuberculous pleural effusion, 3 of them were with pneumonia pleural effusion in cases, one was with nonspecific inflammation incase), the diagnostic rate was 96.1%.②The level of CEA in serum、in pleural effusion and the pleural effusion/serum CEA ratio in the malignant pleural effusion groupobviously were higher than that in pleural effusion group.Therefore, the level of CEA in pleural effusion of ladenocarcinoma were significantly higher than thoseother types of pleural effusion.③The sensitivity of the CEA in pleural effusion, specificity and accuracy ratio (80.4%, 89.3%, 83.7%) were higher than that in serum CEA and the pleural effusion/serum CEA ratio (56.5%, 78.5% and 64.9%, respectively, 93.4%, 64.2%, 82.4%). Conclusions ①Medical thoracoscopy is a safe, effective, practical diagnosis method which is worth to popularizing widely.②The CEA levels in the body, especially in pleural effusion, is significant to diagnosis the malignant pleural effusion(especially in adenocarcinoma). It can be used as an auxiliary diagnostic index for clinical application. Key words: Pleural effusion, malignant; Medical thoracoscopy; The CEA in serum; The CEA in pleural effusion; Pleural effusion/serum CEA ratio