腹水肿瘤标记物对良恶性腹水的鉴别诊断价值(1)
摘要：目的 探讨腹水肿瘤标志物在良恶性腹水鉴别诊断中的应用价值。方法 选取2017年6月～2019年6月庆阳市人民医院收治的30例肿瘤疾病伴腹水患者为恶性组，另选择同期住院的45例相应良性疾病伴腹水患者为良性组，比较两组腹水肿瘤标志物水平，并采用ROC曲线分析恶性组腹水肿瘤标志物(CEA、CA125、CA153、CA199、铁蛋白、AFP、SCC)的诊断价值。结果恶性组腹水肿瘤标志物CEA、CA125、CA153、CA199、铁蛋白、AFP水平高于良性组，差异有统计学意义(P<0.05);两组SCC水平比较，差异无统计学意义(P>0.05)。恶性组腹水肿瘤标志物CEA、SCC、CA125、CA153、CA199、铁蛋白、AFP的ROC曲线下面积分别为0.885、0.691、0.815、0.934、0.685、0.771、0.759。结论 腹水肿瘤标志物CEA、CA125、CA153、铁蛋白、AFP在恶性腹水的鉴别诊断中均具较高的诊断价值。
关键词：腹水;肿瘤标志物;诊断价值
中图分类号：R730.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.11.057
文章编号：1006-1959(2020)11-0173-02
Abstract：Objective To explore the application value of ascites tumor markers in the differential diagnosis of benign and malignant ascites.Methods 30 patients with tumor disease and ascites admitted to Qingyang People's Hospital from June 2017 to June 2019 were selected as the malignant group， and 45 patients with benign disease and ascites hospitalized in the same period were selected as the benign group， compare the levels of ascites tumor markers between the two groups， the ROC curve was used to analyze the diagnostic value of ascites tumor markers (CEA， CA125， CA153， CA199， ferritin， AFP， SCC) in malignant group.Results The levels of ascites tumor markers CEA， CA125， CA153， CA199， ferritin， and AFP in the malignant group were higher than those in the benign group，the difference was statistically significant (P<0.05); the SCC levels in the two groups were not statistically significant (P>0.05).The areas under the ROC curve of the ascites tumor markers CEA， SCC， CA125， CA153， CA199， ferritin， and AFP in the malignant group were 0.885， 0.691， 0.815， 0.934， 0.685， 0.771， and 0.759， respectively.Conclusion The ascites tumor markers CEA， CA125， CA153， ferritin and AFP have high diagnostic value in the differential diagnosis of malignant ascites.
Key words：Ascites;Tumor markers;Diagnostic value
腹水(ascites)作為临床常见症状之一，常见病因有感染、肝硬化、低蛋白血症、心源性、肾源性、恶性肿瘤等[1]。对于腹水的常规检查和生化检查主要用于鉴别腹水为漏出液或渗出液，但是其对于腹水的良恶性鉴别缺乏较高的特异性。随着恶性腹水患者逐渐增多，良、恶性腹水的鉴别对于疾病的诊断、监测、预后均具有重要意义[2]。既往临床主要依赖于细胞学检查来鉴别良恶性腹水，其作为良恶性腹水鉴别诊断的金标准具有较高特异性，但检出的阳性率较低[3]。因此，寻求一种敏感度、特异度均较高的良恶性腹水的鉴别方法尤为重要。肿瘤标志物是肿瘤细胞直接分泌、脱落到体液或组织中的物质，也包含部分人体对肿瘤产生的免疫标志物。因此，肿瘤标志物的检测具有准确率高、反应敏感的特点，对良恶性腹水的鉴别有一定的应用价值[4]，但目前临床主要是以血清肿瘤标志物的检测为主，对于腹水肿瘤标志物的检测价值依然有待进一步明确。本研究主要探讨腹水肿瘤标志物在良恶性腹水鉴别诊断中的应用价值，现报道如下。, 百拇医药(张成宪 李芳玲 马莹)
关键词：腹水;肿瘤标志物;诊断价值
中图分类号：R730.6 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.11.057
文章编号：1006-1959(2020)11-0173-02
Abstract：Objective To explore the application value of ascites tumor markers in the differential diagnosis of benign and malignant ascites.Methods 30 patients with tumor disease and ascites admitted to Qingyang People's Hospital from June 2017 to June 2019 were selected as the malignant group， and 45 patients with benign disease and ascites hospitalized in the same period were selected as the benign group， compare the levels of ascites tumor markers between the two groups， the ROC curve was used to analyze the diagnostic value of ascites tumor markers (CEA， CA125， CA153， CA199， ferritin， AFP， SCC) in malignant group.Results The levels of ascites tumor markers CEA， CA125， CA153， CA199， ferritin， and AFP in the malignant group were higher than those in the benign group，the difference was statistically significant (P<0.05); the SCC levels in the two groups were not statistically significant (P>0.05).The areas under the ROC curve of the ascites tumor markers CEA， SCC， CA125， CA153， CA199， ferritin， and AFP in the malignant group were 0.885， 0.691， 0.815， 0.934， 0.685， 0.771， and 0.759， respectively.Conclusion The ascites tumor markers CEA， CA125， CA153， ferritin and AFP have high diagnostic value in the differential diagnosis of malignant ascites.
Key words：Ascites;Tumor markers;Diagnostic value
腹水(ascites)作為临床常见症状之一，常见病因有感染、肝硬化、低蛋白血症、心源性、肾源性、恶性肿瘤等[1]。对于腹水的常规检查和生化检查主要用于鉴别腹水为漏出液或渗出液，但是其对于腹水的良恶性鉴别缺乏较高的特异性。随着恶性腹水患者逐渐增多，良、恶性腹水的鉴别对于疾病的诊断、监测、预后均具有重要意义[2]。既往临床主要依赖于细胞学检查来鉴别良恶性腹水，其作为良恶性腹水鉴别诊断的金标准具有较高特异性，但检出的阳性率较低[3]。因此，寻求一种敏感度、特异度均较高的良恶性腹水的鉴别方法尤为重要。肿瘤标志物是肿瘤细胞直接分泌、脱落到体液或组织中的物质，也包含部分人体对肿瘤产生的免疫标志物。因此，肿瘤标志物的检测具有准确率高、反应敏感的特点，对良恶性腹水的鉴别有一定的应用价值[4]，但目前临床主要是以血清肿瘤标志物的检测为主，对于腹水肿瘤标志物的检测价值依然有待进一步明确。本研究主要探讨腹水肿瘤标志物在良恶性腹水鉴别诊断中的应用价值，现报道如下。, 百拇医药(张成宪 李芳玲 马莹)
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