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中华肺部疾病杂志(电子版) ›› 2026, Vol. 19 ›› Issue (02) : 330 -334. doi: 10.3877/cma.j.issn.1674-6902.2026.02.024

综述

生物标志物在诊断渗出性和漏出性胸腔积液鉴别诊断中的研究进展
陈惠姗1, 曾惠清1,2,()   
  1. 1361004 厦门,厦门大学附属中山医院
    2362002 福州,福建医科大学临床医学院
  • 收稿日期:2025-01-15 出版日期:2026-04-25
  • 通信作者: 曾惠清
  • 基金资助:
    厦门市科技局、厦门市科技计划项目(3502220209022)

Research progress on biomarkers in the differential diagnosis of exudative and transudative pleural effusion

Huishan Chen, Huiqing Zeng()   

  • Received:2025-01-15 Published:2026-04-25
  • Corresponding author: Huiqing Zeng
引用本文:

陈惠姗, 曾惠清. 生物标志物在诊断渗出性和漏出性胸腔积液鉴别诊断中的研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2026, 19(02): 330-334.

Huishan Chen, Huiqing Zeng. Research progress on biomarkers in the differential diagnosis of exudative and transudative pleural effusion[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(02): 330-334.

胸腔积液(pleura effusion)是临床常见的胸膜腔病理性液体积聚症状,精准区分渗出性与漏出性胸腔积液是明确病因、制定治疗方案的关键。传统Light标准作为鉴别金标准,仍存在部分病例误诊、创伤性检测受限等不足,探寻高效、无创、精准的生物标志物成为临床研究热点。生物标志物凭借检测便捷、特异性强、灵敏度高等优势,为胸腔积液性质鉴别提供了全新思路,目前临床及研究中涉及的标志物涵盖炎症相关因子、肿瘤标志物、生化指标、新型分子标志物等多个类别。现有研究证实,降钙素原(procalcitonin, PCT )、C-反应蛋白(C-reactive prote, C-RP)、腺苷脱氨酶(adenosine deaminase, ADA)等传统标志物在感染性渗出液鉴别中具有重要参考价值,癌胚抗原、细胞角蛋白19片段等肿瘤标志物对恶性渗出液筛查敏感度较高,而新型微小RNA、外泌体、趋化因子等标志物,进一步提升了疑难、混合性胸腔积液的鉴别准确率。同时,多种生物标志物联合检测、联合影像学及细胞学检查的综合诊断模式,有效弥补了单一标志物检测的缺陷,大幅降低漏诊与误诊率。但目前部分新型生物标志物仍处于临床前研究阶段,缺乏大样本、多中心临床试验验证,检测标准化、规范化程度不足,临床普及应用存在局限。未来需进一步挖掘高特异性新型生物标志物,建立统一的检测标准与联合诊断体系,推动生物标志物从基础研究走向临床转化,为胸腔积液的早期、精准、无创鉴别诊断提供更可靠的依据,助力临床精准诊疗与患者预后改善。

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