VEGF、CEA联合检测在腹水鉴别诊断中的价值

目的 探讨测定腹水中血管内皮生长因子(VEGF)、癌胚抗原(CEA)在良、恶性腹水鉴别诊断中的价值,以及二者联合检测的临床意义.方法 收集腹水标本61例,分为良性腹水组和恶性腹水组,采用ELISA的方法测定VEGF,放免法测定CEA.结果 恶性腹水组VEGF水平明显高于良性腹水组(P＜0.01);恶性腹水组CEA水平明显高于良性腹水组(P＜0.01).卵巢癌引起的腹水中VEGF的水平显著高于肝癌、胃癌、结肠癌组(P＜0.05).不同肿瘤引起的腹水中CEA的含量无明显差异(P＞0.05).VEGF诊断恶性腹水的敏感性为82.1%,特异性为87.9%,准确率为85.2%.CEA诊断恶性腹水的敏感性为64.3%,特异性为90.9%,诊断准确率为78.7%.同时检测患者腹水VEGF和CEA,其诊断恶性腹水的敏感性为92.9%,特异性为84.8%,诊断准确率为88.5%.结论 腹水中VEGF、CEA测定有助于良、恶性腹水的鉴别诊断;恶性腹水中VEGF的含量对恶性腹水的组织来源可能有一定的鉴别诊断作用;联合检测恶性腹水中的VEGF、CEA水平,可明显提高诊断恶性腹水的敏感性.

The Value of Combined VEGF and CEA Determination in the Differential Diagnosis of Ascites

Objective To investigate the differential diagnostic value of the VEGF and CEA determination in ascites and the clinical significances of VEGF combined with CEA measurement.Methods Collect 61 ascites samples.Divide them into benign ascites and malignant ascites.Determine VEGF and CEA by ELISA and radioinmmunoassay method.Results The VEGF level in malignant ascites was significantly higher than benign ascites(P<0.01) that in nonmalignant ascites.The CEA level in malignant ascites was significantly higher than benign ascites(P<0.01).The VEGF level in malignant ascites of ovarian carcinoma was significantly higher than that of liver cancer or gastric carcinoma or colorectal carcinoma(P<0.05).The CEA level in malignant ascites of those carcinoma did not have the obvious difference(P>0.05),the sensitivity of VEGF to the diagnosis of the malignant ascites is 82.1%,the spciality is 87.9%,the veracity is 85.2%.The sensitivity of CEA to the diagnosis of the malignant ascites is 64.3%,the spciality is 90.9%,the veracity is 78.7%.The sensitivity,speciality and veracity of malignant ascites diagnose by combined measured ascites VEGF and CEA measurement was 92.9%,84.8% and 88.5% respectively.Conclusion The ascites VEGF level of CEA level might contribute to differ benign ascites from malignant ascites.The concertration of VEGF in malignant ascites might has the certain distinction diagnosis function to originates of the malignant ascites.Combined ascites VEGF and CEA level measurement might have a significant value in the differential diagnosis of ascites.