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血管内皮生长因子 糖类抗原199和糖类抗原125对腹腔积液良恶性的鉴别价值 |
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01). The levels of VEGF and CA125 in malignant ascites of ovarian carcinoma group were obviously higher than those of gastric carcinoma, colorectal carcinoma or pancreatic cancer groups (P<0.05). The levels of CA199 in malignant ascites of pancreatic cancer patients were higher than the other three groups, while there was no obvious difference (P>0.05). The rate of sensitivity, specificity and accuracy of VEGF in the diagnosis of the malignant ascites was 84.6%, 84.4% and 84.5%, respectively. The rate of sensitivity, specificity and accuracy of CA199 in the diagnosis of the malignant ascites was 61.5%, 78.1% and 70.7%, respectively. While the rate of sensitivity, specificity and accuracy of CA125 was 69.2%, 56.3% and 62.1%, respectively. Combined determinations of VEGF, CA199 and CA125 showed that the rate of sensitivity, specificity and accuracy was 92.3%,81.3% and 86.2%, respectively, of which the sensitivity was apparently higher than that of determinations of CA199 (P<0.01) or CA125 (P<0.01) alone. Conclusion The determination of VEGF, CA199 and CA125 levels in ascites might contribute to differentiate benign ascites from malignant ascites. The concentrations of VEGF and CA125 in malignant ascites might have the certain functions in the differential diagnosis of the histological origins of the malignant ascites. Combined determinations of ascites VEGF, CA199 and CA125 levels might significantly enhance the sensitivity of malignant ascites diagnosis.
Key words: ascites; vascular endothelial growth factor; CA199; CA125; differential diagnosis
不同疾病导致的腹腔积液其治疗方法和预后截然不同。故病因的鉴别，尤其是良、恶性腹腔积液的鉴别极为重要。传统的腹腔积液化验检查方法特异性和敏感性均较低。腹腔积液细胞学检查特异性高,但敏感性低，故从腹腔积液中寻找理想的肿瘤标记物已成为当前研究的热点。血管内皮生长因子(VEGF)是一种肿瘤生长、浸润和转移的指标，而在恶性腹腔积液中糖类抗原199(CA199)、糖类抗原125(CA125)的表达也明显升高。目前，分别检测此3项指标以鉴别腹腔积液的良恶性的报道较多，而对联合检测的研究相对较少，联合检测3项指标的临床意义也未完全阐明，故本研究分别应用酶联免疫吸附法、电化学发光免疫分析法检测58例患者腹腔积液中的VEGF、CA199和CA125，旨在观察不同病因腹腔积液中VEGF、CA199和CA125的水平，探讨三者在良恶性腹腔积液鉴别诊断中的价值，以及三者联合检测的临床意义。
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