DNA倍体分析联合腹水-血清CEA比值测定对腹水性质鉴别诊断价值论文.docVIP

　　DNA倍体分析联合腹水/血清CEA比值测定对腹水性质鉴别诊断价值论文 【摘要】 目的 探讨应用流式细胞仪(FCM)进行腹水细胞DNA倍体分析，以及联合检测腹水/血清癌胚抗原（CEA）比值对良、恶性腹水的鉴别诊断价值。方法 应用流式细胞术对106例腹水病人（良性腹水50例，恶性腹水56例）进行腹水细胞DNA倍体分析，以腹水细胞中发现异倍体为阳性；同时采用ELISA法进行腹水及血清CEA测定，以血清或腹水CEA浓度 5 μg/L、腹水/血清CEA比值 1为阳性。结果 恶性腹水组病人的腹水/血清CEA比值阳性率及腹水中检出异倍体的阳性率均明显高于良性腹水组。腹水/血清CEA比值阳性和腹水中检出异倍体诊断恶性腹水的灵敏度和特异度分别为51.79%、98.00%和71.43%、86.00%。腹水中检出异倍体与腹水/血清CEA比值阳性联合诊断恶性腹水的灵敏度和特异度分别为92.86%和100%。结论 DNA倍体分析、腹水/血清CEA比值检测对于鉴别良、恶性腹水是有价值的生物学指标，二者联合可以提高鉴别诊断良、恶性腹水的灵敏度和特异度，提高诊断效能。 【关键词】 腹水 癌胚抗原 DNA倍体分析 诊断 鉴别 ［ABSTRACT］ Objective To investigate the differential diagnostic significance of DNA ploidy analysis and ascites/serum carcinoembryonic antigen ratio assay in malignant and benign ascites. Methods Floetry (FCM) e linked immunosorbent assay (ELISA) . CEA value 5 μg/L and ascites/serum CEA ratio 1 CEA, ascitic CEA, ascites/serum CEA ratio and aneuploidy in malignancy CEA ratio in diagnosis of malignant ascites CEA ed the value of ascites/serum CEA ratios assay and DNA ploidy analysis in differential diagnosis of malignant ascites, and the bination of ascites/serum CEA ratios assay and the DNA ploidy analysis could increase sensitivity and specificity of differential diagnosis of malignant ascites from benign ascites. ［KEY alignant ascitesJ. Br J Surg, 1996,83(1):614. 3张炳远,张斌,闫尚伦. 腹腔镜技术对不明原因腹水的诊断价值J. 青岛大学医学院学报, 2003,39(3):231232. 4MUENSTERER O J, AVERBACH A M, JACQUET P, et al. Malignant peritoneal mesothelioma. Casereport demonstrating pitfalls of diagnostic laparoscopyJ. Int Surg, 1997,82(3):240243. 5SARI R, YILDIRIM B, SEVINC A, et al. The importance of serum and ascites fluid alphafetoprotein, carcinoembryonic antigen, CA199, and CA153 levels in differential diagnosis of ascites etiologyJ. Hepatogastroenterology, 2001,48(42):16161621. 6NYSTROM J S, DYCE B, ed, 1977,137(7):875879. 7TRAPE J, MOLINA R, SANT F. Clinical evaluation of the simultaneous determination of tumor markers in fluid and serum and their ratio in the differential diagnosis of