腹水/血清肿瘤标志物对良恶性腹水的鉴别价值

Value of measurement of gradient and ratio of ascites-serum tumor markers in differential diagnosis of tuberculous ascites and malignant ascites

AIM

To assess the value of measurement of the gradient and ratio of ascites-serum tumor markers in the differential diagnosis of tuberculous ascites and malignancy-related ascites.

METHODS

Sixty patients with ascites were divided into two groups, namely, 31 cases of malignant ascites and 31 cases of tuberculous ascites. Tumor markers in serum and ascites were simultaneously detected to calculate and compare the gradient and ratio of serum-ascites tumor markers between the two groups.

RESULTS

The positive rates of CEA and CA199 in the malignant group were significantly higher than those of the tuberculosis group (P < 0.01). The positive rates of CA125 and α-fetoprotein (AFP) showed no significant difference between the two groups (P > 0.05). Ratio analysis of tumor markers in ascites and serum revealed that CA125, CA199, and CEA ratios were statistically significant between the two groups, with CA125 ratio having the most significant difference (P < 0.01). Ascites-serum gradient analysis showed that CA125, CEA, and CA199 gradients were significantly different between the two groups (P < 0.01). The ratio and gradient of AFP were not significantly different between the two groups (P > 0.05).

CONCLUSION

At the cutoff values of CA125 ratio > 2.16, CA125 gradient > 264.05 ng/mL, CEA ratio > 4.8, CEA gradient > 23.05 ng/mL, CA199 ratio > 0.96, and CEA gradient > -0.20 ng/mL, the diagnostic value of combining the gradients and ratios of the three tumor markers are more helpful to distinguish tuberculous ascites and non-liver cancer ascites than any of the three markers alone.

Diagnostic values of DNA-aneuploidy and C-12 analysis for benign and malignant ascites

AIM: To evaluate the diagnostic values of DNA-aneuploidy and tumor markers for benign and malignant ascites.

METHODS: Ascites fluid specimens were collected from 68 patients with ascites(benign 31, malignant 37). Besides routine exfoliated cytology examination, FCM-DNA ploidy analysis was performed, and tumor markers were detected by C-12 multiple tumor marker protein chip.

RESULTS: There were significant differences in DNA index and proliferation index between benign and malignant ascites groups. The sensitivity of FCM-DNA and that of C12 for malignant ascities were 72.97% and 94.59%, respectively while specificities were 93.54% and 54.84%. The accuracy of FCM-DNA and that of C12 were 82.35% and 76.47%, respectively. The combined sensitivity, specificity and accuracy were 94.59%, 96.77% and 82.35%, respectively.

CONCLUSION: Joint detection of DNA-aneuploidy and C-12 multiple tumor marker protein chip could improve the sensitivity and specificity of ascites. They might be of high diagnostic values for benign and malignant ascites and might benefit further clinic procedures.