血清肿瘤标记物、全腹CT、腹水脱落细胞诊断腹水的意义  

Serum tumor markers,whole abdominal CT and peritoneal exfoliated cells in diagnosis of ascites

作　　者：李咏梅[1] 阎国宝[1] 

机构地区：[1]内蒙古医科大学鄂尔多斯临床学院消化内科,内蒙古鄂尔多斯017000

出　　处：《临床荟萃》2014年第5期521-524,共4页Clinical Focus

摘　　要：目的比较血清肿瘤标记物、全腹CT、腹水脱落细胞在腹水诊断中的意义。方法对所选腹水患者进行血清肿瘤标记物、全腹部CT及腹水脱落细胞检查,比较上述3种方法在腹水诊断中各自的阳性率,计算单项及联合检测对恶性腹水的敏感度及特异度。结果单项检测在结核性腹水组中癌抗原125(CA125)的阳性率最高,为86.7%。在恶性腹水组中全腹CT的阳性率最高,为92.9%,CA125的阳性率为78.6%,但特异度仅为22.2%。联合检测对恶性腹水敏感度最高的为全腹CT+脱落细胞或全腹CT+6项肿瘤标记物,为92.9%;特异度最高的为全腹CT+脱落细胞,为50.0%。结论 CA125对结核性腹水及恶性腹水的阳性率均高,但特异度低。单项检测全腹部CT有较好的敏感度和特异度。联合检测可以提高对恶性腹水的敏感度。全腹CT+脱落细胞可以同时保证敏感度和特异度。Objective To compare the significance of serum tumor markers,whole abdominal CT and peritoneal exfoliated cells in the diagnosis of ascites. Methods The serum tumor markers, full abdominal CT and peritoneal exfoliated cells were used for the selected patients, the positive rate, sensitivity and specificity of above three methods were compared in the diagnosis of ascites. Results In the single test, the positive rate of CA125 was the highest in tuberculous ascites,86.7%. The positive rate of whole abdominal CT was the highest in malignant ascites,92.9%. The positive rate of CA125 was 78.6% ,but its specificity was only 22.20//oo. In the joint detection,the highest sensitivity for malignant ascites was whole abdominal CT and exfoliated cells or whole abdominal CT and tumor marker, 92.9 %. The highest specificity for malignant ascites group was the whole abdominal CT plus exfoliated cells, 50.0 ~. Conclusion The positive rate of CA125 in tuberculous aseites and malignant ascites was high, but low specificity. The whole abdominal CT had better sensitivity and specificity in the single test. Joint detection can increase the sensitivity of malignant ascites. Whole abdominal CT and exfoliated cells can simultaneously ensure the sensitivity and specificity.

关 键 词：结核 肝硬化 腹水 

分 类 号：R52[医药卫生—内科学]