肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值

目的 探讨肿瘤标志物CEA 、CA199、CA125在细胞学阴性的恶性腹水中的诊断价值.方法 检测189例腹水患者的血清和腹水肿瘤标记物,评估肿瘤标记物在细胞学阴性的恶性腹水中的诊断价值.结果 在预设的临界值,细胞学阴性的恶性腹水患者血清和腹水CEA 、CA19-9阳性率明显高于良性腹水组（P ＜0.05）;CA12-5两组比较,差异无统计学意义（P＞0.05）.血清CEA 、CA19-9诊断敏感性较低;腹水CEA 、CA19-9诊断敏感性明显提高,特异性相当.腹水CEA、CA19-9的ROC曲线下面积分别为0.94、0.88.结论 肿瘤标记物CEA、CA19-9有助于细胞学阴性恶性腹水的鉴别诊断,CA12-5无诊断价值;其中腹水CEA诊断价值较高.

Diagnostic value of tumor markers in cytologically negative malignant ascites

Objective To explore diagnostic value of tumor markers CEA,CA19-9 and CA12-5 in cytologically negative malignant ascites.Methods Tumor markers in 189 patients with ascites were detected in serum and ascitic fluid,and then diagnostic value of tumor markers was evaluated in cytologically negative malignant ascites.Results At the predetermined cut-off values,positive rate of serum and ascitic CEA,CA19-9 in cytologically negative malignant ascites were higher than those in benign ascites,CA12-5 showed no difference between two groups.Serum CEA and CA19-9 yielded low sensitivity.Diagnostic sensitivity of ascitic CEA,CA19-9 were improved,the specificity was equivalent.Areas under ROC curves of ascitic CEA,CA19-9 were 0.94,0.88,respectively.Conclusion The detection of tumor markers CEA,CA19-9 provide the assistance in the diagnosis of cytologically negative malignant ascites,CA12-5 shows no value in differential diagnosis; ascitic CEA yields the best value.