腹水-血清CA125梯度在腹水性质分析中的意义

目的探讨腹水-血清CA125梯度在腹水性质分析中的意义。方法对37例肝硬化腹水、19例自发性腹膜炎、16例结核性腹膜炎及28例腹膜转移癌患者的血清、腹水CA125水平以及腹水-血清CA125梯度进行检测,并以20例健康人血清CA125为对照组比较分析。结果不同性质腹水患者的血清CA125明显高于正常对照组（P〈0.01）,但彼此之间差异无统计学意义（P〉0.05）;自发性腹膜炎、结核性腹膜炎及腹膜转移癌患者腹水CA125明显高于肝硬化腹水组（P〈0.05）,但彼此之间差异无统计学意义（P〉0.05）;不同性质腹水患者的腹水、血清CA125水平之间显著相关（P〈0.01或P〈0.05）;自发性腹膜炎、结核性腹膜炎及腹膜转移癌患者腹水-血清CA125梯度明显高于肝硬化腹水组,腹膜转移癌患者更为明显（P〈0.01）,与自发性腹膜炎、结核性腹膜炎组比较差异有统计学意义（P〈0.05）。结论血清、腹水CA125均为非特异性腹水标志物之一,对鉴别腹水性质的意义不大,但腹水CA125可能在渗出液和漏出液的鉴别中具有重要意义,而腹水-血清CA125梯度更有助于腹水性质的分析。

Role of ascites-serum CA125 gradient in the analysis of ascitic aetiology

Objective To study the role of ascites-serum CA125 gradient in the analysis of ascitic aetiology.Methods Serum CA125,ascites CA125,and ascites-serum CA125 gradient were measured and analyzed in 37 cases with liver cirrhosis,19 cases with spontaneous bacterial peritonitis,16 cases with tuberculous peritonitis,28 cases with peritoneal metastatic carcinoma,20 healthy subjects.Results Serum CA125 in patients with ascites was significantly higher than that in healthy subjects （P0.01）. There was no significant difference of serum CA125 concentrations among the cases with ascites of different diseases. Ascites CA125 in patients with spontaneous bacterial peritonitis,tuberculous peritonitis and peritoneal metastatic carcinoma was significantly higher than that in patients with liver cirrhosis （P0.05）,but there was no significant difference of ascites CA125 concentrations among the three groups above. There were significant correlation between the ascites CA125 and the serum CA125 in patients with different causes（P0.01 or P0.05）. Ascites-serum CA125 gradient in patients with spontaneous bacterial peritonitis,tuberculous peritonitis and peritoneal metastatic carcinoma was significantly higher than that in patients with liver cirrhosis,specifically that in patients with peritoneal metastatic carcinoma （P0.01）. There was significant difference of ascites-serum CA125 gradient among the three groups （P0.05）.Conclusion Serum CA125 and ascites CA125 are both non-specificity markers of no clinical significance in the differential diagnosis of ascitic aetiology. But ascites CA125 maybe play the role in the differential diagnosis of effusion and transudation. Ascites-serum CA125 gradient might play significant role in analysis of ascitic aetiology.