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目的探讨测定腹水中血管内皮生长因子(VEGF)、癌胚抗原(CEA)在良、恶性腹水鉴别诊断中的价值,以及二者联合检测的临床意义。方法收集腹水标本61例,分为良性腹水组和恶性腹水组,采用ELISA的方法测定VEGF,放免法测定CEA。结果恶性腹水组VEGF水平明显高于良性腹水组(P<0.01);恶性腹水组CEA水平明显高于良性腹水组(P<0.01)。卵巢癌引起的腹水中VEGF的水平显著高于肝癌、胃癌、结肠癌组(P<0.05)。不同肿瘤引起的腹水中CEA的含量无明显差异(P>0.05)。VEGF诊断恶性腹水的敏感性为82.1%,特异性为87.9%,准确率为85.2%。CEA诊断恶性腹水的敏感性为64.3%,特异性为90.9%,诊断准确率为78.7%。同时检测患者腹水VEGF和CEA,其诊断恶性腹水的敏感性为92.9%,特异性为84.8%,诊断准确率为88.5%。结论腹水中VEGF、CEA测定有助于良、恶性腹水的鉴别诊断;恶性腹水中VEGF的含量对恶性腹水的组织来源可能有一定的鉴别诊断作用;联合检测恶性腹水中的VEGF、CEA水平,可明显提高诊断恶性腹水的敏感性。
Objective To investigate the value of determination of vascular endothelial growth factor (VEGF) and carcinoembryonic antigen (CEA) in the differential diagnosis of benign and malignant ascites ascites and their clinical significance. Methods Sixty - one ascites samples were collected and divided into benign ascites group and malignant ascites group. ELISA was used to determine VEGF, and CEA was determined by radioimmunoassay. Results The VEGF level in malignant ascites group was significantly higher than that in benign ascites group (P <0.01). The CEA level in malignant ascites group was significantly higher than that in benign ascites group (P <0.01). The level of VEGF in ascites caused by ovarian cancer was significantly higher than that in liver cancer, gastric cancer and colon cancer (P <0.05). CEA levels in ascites caused by different tumors showed no significant difference (P> 0.05). The sensitivity and specificity of VEGF in the diagnosis of malignant ascites were 82.1%, 87.9% and 85.2% respectively. CEA diagnosis of malignant ascites sensitivity was 64.3%, specificity was 90.9%, diagnostic accuracy was 78.7%. At the same time, the detection of ascites VEGF and CEA in patients with ascites was 92.9%, specificity 84.8%, diagnostic accuracy 88.5%. Conclusion The determination of VEGF and CEA in ascites is helpful for the differential diagnosis of benign and malignant ascites. The content of VEGF in malignant ascites may have some differential diagnosis on the origin of malignant ascites. Combined detection of VEGF and CEA in malignant ascites Significantly improve the sensitivity of the diagnosis of malignant ascites.