【摘要】 目的 :分析血清及腹水癌胚抗原(carcinoembryonic antigen, CEA)、糖链抗原19-9(carbohydrate antigen19-9, CA19-9)及糖链抗原-125(carbohydrate antigen 125, CA125)水平在良、恶性腹水鉴别诊断中的应用价值。方法 :选择良性腹水患者67例,恶性腹水患者44例,回顾性研究患者血清及腹水中CEA、CA19-9及CA125的水平,通过绘制受试者工作特征曲线(receiver operating characteristic curve, ROC曲线),分析这些肿瘤指标对腹水良、恶性的鉴别诊断价值及最佳截点、灵敏度、特异度和准确度,并进一步探讨联合检测对腹水鉴别诊断的价值。结果:患者血清中的CEA和CA125水平在良、恶性腹水两组间差异均无统计学意义(均P>0.05),但血清中CA19-9水平在恶性腹水组中明显高于良性腹水组(P<0.05),诊断界值为46.75 U/mL。患者腹水中的CEA、CA19-9及CA125水平在恶性腹水组中均明显高于良性腹水组(均P<0.05),三者的诊断界值分别为1.50 ng/mL、26.90 U/mL及822.95 U/mL。腹水CEA分别与血清CA19-9或腹水CA19-9联合检测可以大大提高对恶性腹水诊断的灵敏度,且保持较好的诊断特异度及准确度。结论:血清CEA和CA125对良、恶性腹水无鉴别诊断价值;血清CA19-9和腹水CEA、CA19-9及CA125对良、恶性腹水有鉴别诊断价值;联合检测血清及腹水的肿瘤指标,可提高对恶性腹水的诊断与价值。更多还原

【Abstract】 Objective: To analyze the application value of serum and ascites carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 125(CA125) in differential diagnosis of benign and malignant ascites. Methods:67 patients with benign ascites and 44 patients with malignant ascites were selected, to study retrospectively levels of serum and ascites CEA, CA19-9 and CA125. By drawing receiver operating characteristic curve(ROC curve), the value of these tumor indexes in the differential diagnosis of ascites, the best cut-off point, sensitivity, specificity and accuracy were analyzed, and the value of combined detection in the differential diagnosis of ascites was further discussed. Results: There was no significant difference in serum CEA and CA125 levels between benign and malignant ascites(P>0.05), but the serum CA19-9 level in malignant ascites was significantly higher than that in benign ascites(P<0.05), and the diagnostic threshold was 46.75 U/mL.The levels of CEA, CA19-9 and CA125 in the ascites of patients with malignant ascites were significantly higher than those of patients with benign ascites(P<0.05). The diagnostic thresholds of these three indicator were 1.50 ng/mL, 26.90 U/mL and822.95 U/mL respectively. The combined detection of CEA in ascites and serum CA19-9 or CA19-9 in ascites can greatly improve the sensitivity of the diagnosis of malignant ascites, and maintain a good specificity and accuracy of the diagnosis.Conciusion: Serum CEA and CA125 have no value in differential diagnosis of benign and malignant ascites; serum CA19-9 and ascites CEA, CA19-9 and CA125 have value in differential diagnosis of benign and malignant ascites; combined detection of tumor indexes of serum and ascites can improve the value in diagnosis of malignant ascites.更多还原