CA125、CEA、AFP检测在结核性腹水及恶性腹水鉴别诊断中的价值

目的 :探讨 CA1 2 5、CEA、AFP检测在良恶性腹水鉴别诊断中的价值。方法 :采用酶联免疫分析法 ( ELISA)分别检测 1 8例结核性腹水、46例恶性腹水患者血清及腹水中CA1 2 5、CEA、AFP水平 ,并进行比较分析。结果 :结核性腹水、原发性肝癌及卵巢癌腹水患者血清 CA1 2 5水平明显高于对照组 ( P<0 .0 1 ) ;恶性腹水与良性腹水间无显著性差异 ( P>0 .0 5 ) ;当 CA1 2 5≥ 2 0 0 U/ml时 ,恶性腹水阳性率明显高于结核性腹水 ( P<0 .0 5 )。 3组血清及腹水中 CEA水平无明显差异 ( P>0 .0 5 )。原发性肝癌患者血清及腹水中 AFP水平明显高于其它组 ( P<0 .0 1 )。结论 :若以血清 CA1 2 5≥ 2 0 0 U/ml为阳性界值时 ,血清 CA1 2 5检测有助于良恶性腹水的鉴别 ;血清及腹水中 CEA水平对良恶性腹水的鉴别无明显意义 ;血清及腹水中 AFP检测有助于原发性肝癌腹水的诊断。

Value of measurement of CA125,CEA and AFP in differential diagnosis of tuberculous ascites and malignancy-related ascites

Objective:To explore the value of measurement of CA125,CEA and AFP in differential diagnosis of malignancy-related ascites and non-malignant ascites. Methods:ELISA was used to measure the levels of serum CA125,CEA and AFP in sera and ascites in 18 cases of tuberculous ascites and 46 cases of malignancy-related ascites. Results:Serum CA125 level was remarkably higher in patients with tuberculous ascites,ovarian tumor ascites and primary cirrhotic ascites than that in control group(P<0.01),but there was not significant difference between group of malignancy-related ascites and group of non-malignant ascites(P>0.05). In CA125≥200U/ml group the positive rate of malignancy-related ascites was remarkably higher than that of tuberculous ascites(P>0.05). The CEA levels in sera and ascites were not statistically different in 3 groups(P>0.05). The AFP levels in sera and ascites in patients with primary cirrhotic ascite was significantly higher than that of other respective groups(P<0.01). Conclusion:At the cut off value of 200U/ml of CA125,the detection of serum CA125 is helpful to the differential diagnosis of malignancy-related and non-malignant ascites. The detection of serum CEA in sera and ascites doesn't have significant value in diagnosing malignancy-related and non-malignant ascites. The detection of AFP in sera and ascites is helpful to diagnose the primary cirrhotic ascites.