悪性胸膜中皮腫のCEA値に関する検討-殊に, 肺癌胸水貯留症例との鑑別診断上の有用性に関して
作者： Takashi Nakano , Hiroshi Fujioka , Juichiroh Maeda , Kei Yamaguchi , Noriaki Iwahashi
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摘要: 悪性胸膜中皮腫と肺癌胸水貯留例との鑑別にCEAが役立つか否か検討した. 悪性胸膜中皮腫 (11例) の胸水CEAは低値であり, 結核性胸膜炎 (18例) 及び他の良性疾患 (21例) のそれとに差はなかった. 又, 肺癌各組織型 (腺癌34例, 小細胞癌18例, 扁平上皮癌8例, 大細胞癌5例) 及び転移性悪性胸膜腫瘍 (13例) のそれは中皮腫よりも有意に高値を示していた. 胸水CEAのcut-off valueを5.0ng/mlとすると腺癌でのpositive rateは82.4%, 小細胞癌28.6%, 扁平上皮癌62.5%, 大細胞癌83.3%, 転移性胸膜腫瘍43.8%であったのに比べ, 中皮腫は全例ともにcut-off level以下であった. 悪性胸膜中皮腫の腫瘍組織CEA染色は全例陰性であり, 血清CEAは病期が進行しても全例ともに正常値内にあった. 以上の結果より, 本疾患のCEAは胸水及び血清ともに上昇しないと考えられ, この点が肺癌胸水貯留例, 殊に問題となる肺腺癌との鑑別に役立つと考えられる.
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