甲胎蛋白、糖类抗原19-9、癌胚抗原联合检测对恶性腹腔积液的诊断价值~

Diagnostic value ofα-fetoprotein,carbohydrate antigen 19-9,and carcinoembryonic antigen combined detection for malignant ascites

目的 探讨甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)联合检测对恶性腹腔积液的诊断价值。方法 根据腹腔积液性质的不同将103例腹腔积液患者分为对照组(n=50,良性腹腔积液)和观察组(n=53,恶性腹腔积液)。比较两组患者腹腔积液中AFP、CA19-9、CEA水平。以病理检查结果为金标准,分析AFP、CA19-9、CEA单独及联合检测对恶性腹腔积液的诊断价值,采用Kappa检验进行一致性分析。应用受试者工作特征(ROC)曲线及曲线下面积(AUC)评估AFP、CA19-9、CEA单独及联合检测对恶性腹腔积液的诊断价值。结果 观察组患者的AFP、CA19-9、CEA水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。AFP、CA19-9、CEA联合检测诊断恶性腹腔积液的灵敏度、特异度、准确度分别为94.34%、96.00%、95.15%,均高于AFP、CA19-9、CEA单独检测。AFP、CA19-9、CEA单独及联合检测诊断恶性腹腔积液与病理检查的一致性Kappa值分别为0.43、0.56、0.53、0.92。ROC曲线显示,AFP、CA19-9、CEA联合检测诊断恶性腹腔积液的AUC为0.968,高于单独检测的0.794、0.827、0.816。结论 AFP、CA19-9、CEA联合检测对恶性腹腔积液具有较高的诊断价值,值得临床推广。

Objective To investigate the diagnostic value ofα-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),and carcinoembryonic antigen(CEA)combined detection for malignant ascites.Method A total of 103 patients with ascites were divided into control group(n=50,benign ascites)and observation group(n=53,malignant ascites)according to the condition of the ascites.The levels of AFP,CA19-9,and CEA in the ascites of the two groups were compared.Us-ing pathological examination results as the gold standard,the diagnostic value of AFP,CA19-9,and CEA alone and in combination detection for malignant ascites were analyzed.Kappa test was used for consistency analysis.The diagnostic value of AFP,CA19-9,and CEA alone and in combination detection for malignant ascites were evaluated using the receiv-er operating characteristic(ROC)curve and the area under the curve(AUC).Result The AFP,CA19-9,and CEA levels in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).The sensitivity,specificity,and accuracy of combined detection of AFP,CA19-9,and CEA in diag-nosing malignant ascites were 94.34%,96.00%,and 95.15%,respectively,which were higher than those of AFP,CA19-9,and CEA alone detection.The consistency Kappa values of AFP,CA19-9,and CEA alone and combined detection in the diagnosis of malignant ascites with pathological examination were 0.43,0.56,0.53,and 0.92 respectively.The ROC curve shows that the AUC of combined detection of AFP,CA19-9,and CEA in diagnosing malignant ascites was 0.968,which was higher than 0.794,0.827,and 0.816 of alone detection.Conclusion The combined detection of AFP,CA19-9,and CEA has high diagnostic value for malignant ascites and is worthy of clinical promotion.