肿瘤标志物联合检测对良、恶性腹水的诊断价值  

Diagnostic value of combined assays of tumor markers in serum to patients with benign or malignant ascites

作　　者：李春艳[1] 刘丽娜[1] 

机构地区：[1]大连医科大学附属第一医院消化内科,辽宁大连116011

出　　处：《大连医科大学学报》2008年第6期559-561,共3页Journal of Dalian Medical University

摘　　要：[目的]探讨联合检测血清肿瘤标志物对良、恶性腹水的诊断价值。[方法]检测28例肝硬化腹水患者,36例消化系肿瘤伴有腹水患者,及11例结核性腹膜炎患者三组病例的血清甲胎蛋白(AFP)、癌胚抗原(CEA)、糖链抗原(CA199)、癌抗原(CA125)水平。[结果]消化系肿瘤患者血清AFP、CEA水平及阳性率高于另两组,肝硬化组和消化系肿瘤组血清CA 199均高于结核性腹膜炎组,CA125水平三组差异无统计学意义。恶性腹水组除CA125升高外,同时有AFP、CEA、CA199至少1项异常升高者占23例。联合检测AFP、CEA、CA199的特异性、敏感性提高。[结论]联合检测有利于良、恶性腹水的鉴别。血清CA125的单项升高提示良性而非恶性腹水。[ Objective ] To evaluate the diagnostic value of the combined assays of tumor markers in serum for patients with benign or malignant ascites. [ Methods ] The serum levels of cancer antigen 125 （ CA125 ）, carbohydrate antigen 199 （ CA199）, carcinoembryonic antigen （ CEA）, alpha fetoprotein （AFP） were determined in 28 patients of liver cirrhosis with ascites,36 patients of digestive malignant tumors with ascites, and 11 patients of tuberculous peritonitis. [ Results ] The serum levels and the positive rates of AFP, CEA in the group of digestive malignant tumors were higer than those in other groups. Serum CA199 levels in patients with liver cirrhosis and digestive malignant tumors were higher than those in patients with tuberculous peritonitis. No difference on the level of serum CA125 was found among the three groups. Among the patients with malignant ascites, an elevation of serum CA125 accompanied with a rise of other tumor markers was observed in 23 cases. The combined assays of tumor markers （ AFP, CEA, CA199） in serum can enhance the diagnostic accuracy. [ Conclusion ] The combined assays of serum tumor markers can help to differentiate benign ascites from malignant ascites. It usually predicts benign ascites if the elevation of serum CA125 is not accompanied with a rise of other tumor markers.

关 键 词：肿瘤标志物 良性腹水 恶性腹水 诊断 

分 类 号：R446.6[医药卫生—诊断学]