高荧光细胞和血清腹水白蛋白梯度在恶性腹水诊断中的价值  

Clinical role of high-fluorescent cell and serum ascites albumin gradient in the diagnosis of malignant ascites

作　　者：孙静芳 刘云 蒋清清 宋爽 李世宝 马萍 丁爽 SUN Jingfang;LIU Yun;JIANG Qingqing;SONG Shuang;LI Shibao;MA Ping;DING Shuang(Department of Clinical Laboratory,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,Jiangsu,China)

机构地区：[1]徐州医科大学附属医院检验科,江苏徐州221002

出　　处：《检验医学》2022年第1期60-62,共3页Laboratory Medicine

基　　金：国家自然科学基金青年基金项目(81900106)。

摘　　要：目的探讨高荧光细胞(HFC)和血清腹水白蛋白梯度(SAAG)诊断恶性腹水的价值。方法选取202例出现腹水的患者,依据脱落细胞学检查结果分为恶性腹水组(36例)和良性腹水组(166例),分析HFC和SAAG在良、恶性腹水组中的分布差异。采用受试者工作特征(ROC)曲线评价各项指标单项及联合检测诊断恶性腹水的效能。结果恶性腹水组高荧光细胞绝对值(HF#)和高荧光细胞百分比(HF%)均显著高于良性腹水组(P=0.0000、P=0.0001),SAAG水平显著低于良性腹水组(P=0.0000)。HF#、HF%和SAAG诊断恶性腹水的曲线下面积分别为0.797、0.704、0.770。单项指标分析时,HF#和SAAG的敏感性、特异性、准确性分别为83.3%、66.9%、69.8%和88.9%、62.0%、66.8%,HF#和SAAG串联检测的敏感性、特异性、准确性分别为77.8%、80.1%、79.7%,HF#和SAAG并联检测的敏感性、特异性、准确性分别为94.4%、48.8%、56.9%。结论HF和SAAG联合检测诊断恶性腹水的敏感性有所下降,但特异性和准确性均明显升高,更有利于恶性腹水的诊断。Objective To investigate the clinical role of high-fluorescent cell(HFC)and serum ascites albumin gradient(SAAG)in the diagnosis of malignant ascites.Methods Totally,202 patients with ascites were enrolled.The patients were classified into malignant group(36 cases)and benign group(166 cases)according to the results of exfoliative cytology.The distribution of HFC and SAAG in the 2 groups was analyzed,and the efficiency of single and combined determinations was evaluated.Results The levels of the absolute value of highfluorescent cell(HF#)and the percentage of high-fluorescent cell(HF%)in malignant group were higher than those in benign group(P=0.0000、P=0.0001),and the level of SAAG was lower than that in benign group(P=0.0000).The areas under curves of HF#,HF%and SAAG for the diagnosis of malignant ascites were 0.797,0.704 and 0.770,respectively.The sensitivities,specificities and accuracies of HF#and SAAG single determinations were 83.3%,66.9%,69.8%and 88.9%,62.1%,66.8%,respectively.The sensitivity,specificity and accuracy of HF#and SAAG combined determination in series were 77.8%,80.1%,79.7%,respectively.The sensitivity,specificity and accuracy of HF#and SAAG combined determination in parallel were 94.4%,48.8%,56.9%,respectively.Conclusions Although the sensitivity decreases after HFC and SAAG combined determination,the specificity and accuracy are both increased,which is more conducive to the diagnosis of malignant ascites.

关 键 词：高荧光细胞 血清腹水白蛋白梯度 恶性腹水 

分 类 号：R446.11[医药卫生—诊断学]