血清及腹腔积液肿瘤标志物联合检测的临床应用价值

目的 探讨血清及腹腔积液甲胎蛋白（AFP）、癌胚抗原（CEA）、糖蛋白抗原199（CA199）、CA724、CA125联合检测对良、恶性腹腔积液鉴别诊断的价值。方法 选择2011年1月至2013年10月确诊为腹腔积液患者144例，分为良性组（79例）和恶性组（65例），对所有患者抽取腹腔积液标本和采集血清标本，采用化学发光法测定AFP和CEA，采用免疫放射分析法测定CA199、CA724和CA125。比较两组患者血清及腹腔积液肿瘤标志物的水平以及单项检测和联合检测的准确性。结果 恶性组患者血清及腹腔积液中AFP、CEA、CA199水平均值明显高于良性组，差异有统计学意义（P〈0.01）。血清及腹腔积液AFP、CEA及CA199联合检测恶性腹腔积液的准确性分别为79.17%、85.42%；血清及腹腔积液CEA、CA125及CA199联合检测恶性腹腔积液的准确性分别为77.78%、81.25%，血清及腹腔积液CEA、CA199及CA724联合检测恶性腹腔积液的准确性分别为77.78%、84.72%。多项肿瘤标志物联合检测恶性腹腔积液的诊断准确性显著高于单项检测，差异均有统计学意义（P〈0.05）。结论 血清及腹腔积液肿瘤标志物联合检测可提高恶性腹腔积液诊断的敏感性和准确性。

Clinical application value of simultaneous determination of tumor markers in serum and ascites

Objective To investigate the value of the simultaneous determination of alpha fetal protein （AFP）,carcinoembryonic antigen （CEA）,carbohydrate antigen 199 （CA199）,CA724,CA125 in serum and ascites for the differential diagnosis of benign and malignant ascites. Methods A total of 144 patients with ascites who were diagnosed from January 2011 to October 2013 were selected and divided into the benign group（n=79） and the malignant group（n=65）. Ascites and serum specimens were simultaneously collected from all the patients. AFP and CEA were determined by chemiluminescence. CA199 ,CA724 and CA125 were determined by radioimmunoassay. Then ,the levels of tumor markers in serum and ascites as well as the accuracy of single and combined detection were compared in the two groups. Results The concentrations of tumor markers AFP,CEA and CA199 in serum and ascites in the malignant group were significantly higher than those in the benign group with statistical difference （P〈0.05）. The accuracy of combined detection of AFP,CEA,CA199 in serum and ascites was 79.17%and 85.42%respectively,the accuracy of combined detection of CEA ,CA125 and CA199 in serum and ascites was 77.78%and 81.25%respectively ,and the accuracy of combined detection of CEA ,CA199 and CA724 in serum and ascites was 77.78%and 84.72%respectively. Simultaneous determination of multi-tumor markers was significant better than single determination on diagnosis accuracy. The differences are stastically significant（P〈0.05）. Conclusion The simultaneous determination of tumor markers in serum and ascites can improve the sensibility and accuracy of malignant ascites diagnosis ,and it is helpful to differentiate benign and malignant ascites.