CA－50、SA诊断癌性腹水的临床价值

Clinical Value of Diagnosis of Carcinous Asciteswith CA-50 and Sialic Acid

本实验采用ＣＡ－５０、ＳＡ检测了６８例良恶性腹水标本。ＣＡ－５０以８ｕ·ｍｌ－１、ＳＡ以５００ｍｇ·Ｌ－１为断点值，其特异度、灵敏度和准确度分别为９１．８％与８０．９％，８１％与７１．４％，９１．２％与７７．９％。两者联合诊断，价值提高。以任何一项阳性作诊断标准，灵敏度可达９５．２％；以两项全部阳性作为诊断标准，特异度和准确度分别为９７．９％与８５．３％。作者认为，ＣＡ－５０、ＳＡ作为肿瘤标志物，对诊断、鉴别诊断和筛选癌性腹水具有重要价值。

The ascitic fluid of 68 patients (21 carcinous,28 cirrhotic and 19 tuberculous were measured with CA- 50 and sialic acid.The CA- 50 concentration in carcinous ascitic fluid was 38.23 ± 33.21 u.ml-1)(mean±SD),which was significantly higer than in cirrhotic (3.43± 2.19 u.ml-1)or in tuberculous(2. 89±1. 69 u.m-1)(P<0.01,for each).At a cut-off point of 8 u.ml-1,the sensitivity.Specificity and accuracy for diagnosing carcinous ascites were 81.9%.91. 8% and 91.2 % ,respectively.The sialic acid concentration in carcinous ascitic fluid was 539.76 ±152.31 mg.L-1 (mean±SD),which was significantly more than in cirrholic(286.86±119.32 mg.L-1 (P<0.01),but in tuberculous ascitic fluid was 520.89 ±179.06 mg.L-1 (P>0.05).Sialic acid was taken 500 mg.L-1 as the cut off point for diagnosing carcinous ascites. The sensitivily specificily and accuracy were 71.4% ,80.9% and 77.9 %,respectively. If these. two markers were combined to use,the sensitivily,specificey and accuracy were raised to 95.2%,97.9% and 85.3%,respectively. The authors conclude that both CA- 50 and sialic acid in ascites are regarded as accurate markers of neoplastic involvement for the peritoneum.