血清及腹水肿瘤标志物诊断良恶性腹水的临床研究

目的分析血清及腹水肿瘤标志物在诊断腹水良恶性中的应用价值,为临床提供参考。方法选择该院2015年11月至2016年6月收治的腹水患者168例作为研究对象,所有患者均经腹腔穿刺采集腹水,分析腹水中的肿瘤标志物,静脉穿刺采集血液,离心取上层血清检测肿瘤标志物糖类抗原153(CA153)、肿瘤相关物质(BXTM)与癌胚抗原(CEA),所有患者均进行病理活检确诊腹水的良恶性。采用正态分布法确定腹水和血清的恶性标准,以病理诊断结果为金标准,采用四格诊断表,分别计算腹水肿瘤标志物和血清肿瘤标志物不同组合诊断腹水良恶性方案的灵敏度和特异度。结果 168例患者病理确诊为恶性56例,良性112例,腹水肿瘤标志物不同组合中3种标志物联合检测结果为:恶性57例,良性111例;血清3种肿瘤标志物联合检测结果为:恶性64例,良性104例,腹水中3种肿瘤标志物联合诊断的灵敏度为85.71%,特异度为91.96%,分别高于血清中3种肿瘤标志物联合诊断的特灵敏度(82.41%)和特异度(83.93%)。结论腹水3种肿瘤标志物联合诊断腹水良恶性的灵敏度、特异度较高,可作为患者整体病情诊断的重要辅助手段,为患者后续选择其他检查方法确诊病情提供重要参考,具有一定的临床价值。

Clinical study on diagnosis value of serum and ascites tumor markers in benign and malignant ascites

Objective To analyze the clinical value of serum and ascites tumor markers in the diagnosis of benign and malignant ascites ,and to provide reference for clinical diagnosis and treatment of ascites .Methods A total of 168 patients with ascites in Third Affiliated Hospital of Liaoning University of Chinese Medicine from November 2015 to June 2016 were selected .All patients were collected abdominal paracentesis ascites ,analysis of ascites tumor markers .Vein blood sample were collected ,centrifuged up-per serum and detected tumor markers including CA153 ,BXTM and CEA ,all patients underwent pathological test for diagnosis of benign and malignant ascites .The normal distribution method was used to determine the standard of judging malignant ascites and serum ,with the pathological diagnosis as the gold standard ,the four grid diagnosis table was used to calculate the sensitivity and specificity of different combination of ascites tumor markers and serum tumor markers in diagnosis of benign and malignant ascites . Results Among 168 cases ,56 cases were diagnosed with malignant ascites ,112 cases with benign ascites by pathological test .Com-bined detection results of three tumor markers in ascites :57 cases were malignant ,111 were benign .Combined detection results of three tumor markers in serum :64 cases were malignant ,104 cases were benign .The sensitivity and specificity of three tumor mark-ers in ascites were 85 .71% and 91 .96% respectively ,which were higher than 82 .41% and 83 .93% of the three tumor markers in serum .Conclusion The sensitivity and specificity of three tumor markers in ascites for diagnosis of benign and malignant ascites were superior ,which could be used as an important auxiliary means for diagnosis on the overall condition of patients with ascites , and provides an important reference for the subsequent selection other inspection methods .