腹腔积液与血清CEA比值对恶性腹腔积液的诊断价值及临床应用  

Clinical Significance of Increased Ratio of Ascitic Fluid Contents of CEA to Serum CEA Contents for Diagnosis of Malignancy

作　　者：贺丽雅[1] 孙淑芳[1] 董天睿[2] 苗杰 

机构地区：[1]哈尔滨医科大学附属第一医院核医学科,150001 [2]哈尔滨医科大学附属第一医院妇科,150001 [3]哈尔滨市社会保险事业管理局医院,150030

出　　处：《放射免疫学杂志》2009年第1期54-56,共3页Journal of Radioimmanology

摘　　要：目的:探讨腹腔积液与血清癌胚抗原(CEA)水平及其比值对恶性腹腔积液的诊断价值。方法:检测50例恶性、50例良性腹腔积液患者的腹腔积液和血清CEA水平,并分别计算其腹腔积液与血清CEA比值。结果:恶性组腹腔积液及血清CEA水平和其比值显著高于良性组。恶性组病人腹腔积液CEA水平显著高于其血清CEA水平。分别以腹腔积液CEA水平>19.67μg/L、血清CEA水平>15.01μg/L、腹腔积液与血清CEA之比>2.01作为恶性腹腔积液的诊断标准。在本文100例中3种标准诊断恶性腹腔积液的敏感度、特异度和准确度分别为腹腔积液CEA:32%、92%、62%;血清CEA:28%、90%、59%;腹腔积液与血清CEA之比其敏感度、特异度和准确度分别为66%、94%、80%,其中腹腔积液与血清CEA之比敏感度和准确度均显著高于腹腔积液CEA和血清CEA标准。结论:观察腹腔积液和血清CEA之比更有助于恶性腹腔积液的诊断。Objective To study the significance of increased ratio of ascitic fluid CEA contents to serum CEA contents for diagnosis of malignancy. Methods Serum and ascitic fluid contents were measured with RIA in 50 patients with malignant ascites and 50 patients with ascites due to various benign disorders. Results In patients with malignant ascites, both the serum and ascitic fluid contents of CEA were significantly higher than those in patients with ascites from benign disorders. With malignant ascites, the ascitic fluid CEA contents were significantly higher than the serum CEA contents （ P 〈 0.05 ）, the ratio of ascitic fluid CEA content to serum CEA contents was above 2.01. The ascitic fluid contents in patients with benign disorders were not much different from the serum CEA contents. The diagnostic sensitivity, specificity and accuracy for malignancy with ascitic fluid CEA, serum CEA and ascitic fluid CEA/serum CEA ratio （ cat - off value 2.01 ） were 32%, 92%, 62% and 28%, 90%, 59% and 66%, 94%, 80% respectively. Obviously, the CEA ratio detection yielded the best result. Conclusion Determination of ratio of ascitic fluid CEA content to serum CEA contents （ cat - off value 2.01 ） was very helpful for the establishment of diagnosis of malignancy.

关 键 词：癌胚抗原 恶性腹腔积液 诊断 

分 类 号：R730.53[医药卫生—肿瘤] R446.11[医药卫生—临床医学]