浆膜腔积液肿瘤标志物与血清肿瘤标志物及脱落细胞学相关性探讨  

Research on the correlation of tumor markers in effusions with serum tumor markers and cytology examination

作　　者：李双双[1] 沈洁[2] 刘宝瑞[2] 

机构地区：[1]南京大学医学院,江苏南京210000 [2]南京大学医学院附属鼓楼医院肿瘤中心,南京大学临床肿瘤研究所,江苏南京210000

出　　处：《现代肿瘤医学》2015年第7期995-998,共4页Journal of Modern Oncology

摘　　要：目的:探讨浆膜腔积液肿瘤标志物癌胚抗原(CEA)、糖类抗原199、125、724、153、242(CA199、CA125、CA724、CA153、CA242)及甲胎蛋白(AFP)与同时期血清肿瘤标志物及脱落细胞学之间的关系。方法:选择202例确诊为恶性肿瘤并伴有浆膜腔积液的患者,依据细胞学检查结果分为脱落细胞学阳性组和脱落细胞学阴性组。对脱落细胞学阳性组的恶性浆膜腔积液患者的同一时间点的血清及浆膜腔积液肿瘤标志物水平进行检测分析。并对脱落细胞学阳性组和阴性组间的浆膜腔积液肿瘤标志物检测分析。结果:恶性浆膜腔积液肿瘤标志物水平明显高于血清,二者比较差异有统计学意义(P<0.05)。恶性胸腹腔积液肿瘤标志物与血清肿瘤标志物相关性好(P<0.01)。胃癌患者脱落细胞学阳性组与阴性组的浆膜腔积液肿瘤标志物水平比较发现CEA、CA125、CA199差异无统计学意义(P>0.05),CA724差异有统计学意义(P<0.05)。结论:恶性浆膜腔积液中肿瘤标志物水平与血清中肿瘤标志物水平具有很好相关性,血清肿瘤标志物的检测可以很好的反应恶性浆膜腔积液中肿瘤标志物水平。且胃癌腹水中CA724水平具有辅助诊断浆膜腔积液良恶性的价值。Objective： To investigate the correlations between the tumor markers in effusions and serum. Methods：An analysis was performed on the results of cytology examination and tumor marker levels in serum and malignant effusions among 202 patients with definite history of malignant tumors. The patients were classified into 2 groups according to the positive or negative detection of tumor cells. Results： Serum and effusions levels of CEA,CA199,CA125,CA724,CA153,CA242,AFP in the malign group were statistically different. Levels of tumor markers in malignant effusions were significantly higher in effusions than those in serum and all tumor markers were highly correlated in serum and effusions（ P〈0. 01）. The positive rate of free cancer cells in effusions was not related to the level of CEA,CA125 and CA199（ P〉0. 05）,but related to the level of CA724（ P〈0. 05）. Conclusion： When malignant effusions is suspected,analyzing tumor markers in effusions dose not have any advantage over serum analysis,and CA724 has a higher supplementary diagnostic value for cytology examination in gastric cancer.

关 键 词：恶性胸腹腔积液 肿瘤标志物 脱落细胞学 

分 类 号：R730.58[医药卫生—肿瘤]