联合检测CEA与CA242对恶性腹水的诊断价值

目的:探讨联合检测腹水癌胚抗原(CEA)与糖抗原242(CA242)对恶性腹水的诊断价值。方法:将67例腹水按不同性质分为恶性腹水32例、结核性腹水10例和非结核性良性腹水25例,分别采用化学发光免疫分析法和免疫放射分析法检测腹水中CEA和CA242水平。结果:恶性腹水中CEA水平明显高于良性腹水,以15.8μg/L为界值,其诊断恶性腹水的敏感性、特异性分别为50%和100%;CA242在恶性腹水中浓度亦显著高于良性腹水,如以10.3u/ml为界值,其诊断恶性腹水的敏感性、特异性分别为31.2%和100%;联合检测腹水CEA与CA242,可在诊断特异性不减的情况下对恶性腹水的诊断敏感性提高至65.6%。结论:联合检测腹水CEA和CA242可提高恶性腹水的诊断水平。

The value of combined determination of CEA and CA242 in the diagnosis of malignant ascites

Objectives:To investigate the value of combined determination of CEA and CA242 in the diagnosis of malignant ascites.Methods:Sixty-seven cases were divided into malignant ascites(32 cases),tuberculous ascites(10 cases)and non-tuberculous ascites(25 cases).Ascitic CEA and CA242 were mearured with chemoluminescence immunoassay and immunoradioassay respectively.Results:CEA in malignant ascites was significantly higher than that in benign ascites.If 15.8μg/L was taken as cut-off,the sensitivity and specificity of CEA for diagnosis of malignant ascites were 50% and 100% respectively.CA242 was also higher in malignant ascites than that in benign ascites with the diagnostic sensitivity and specificity of 31.2% and 100% respectively.Combined determination of CEA and CA242 may increase diagnostic sensitivity to 65.5% without decrease of specificity.Conclusions:Combined determination of CEA and CA242 may improve the diagnostic efficacy of malignant ascites.