CEA mRNA,CEA,CA19-9,CA12-5指标诊断恶性腹腔积液的比较

目的比较癌胚抗原信使核糖核酸(CEA mRNA)、癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、糖链抗原12-5(CA12-5)指标诊断恶性腹腔积液的应用价值。方法恶性腹腔积液、良性腹腔积液各43份,应用逆转录套式聚合酶链反应(RT-NP-PCR)检测CEA mRNA、磁性抗体分离酶免疫测定技术(MAIA)测定CEA,CA19-9和CA12-5。结果恶性与良性腹腔积液检测CEA mRNA,CEA,CA19-9,CA12-5的阳性结果[n(%)]为:33(76.7),23(53.5),25(58.1),35(81.4)与3(7.0),4(9.3),0,30(69.8)。各指标诊断恶性腹腔积液的特异性、敏感性、阳性预测值、阴性预测值和准确性分别为,CEA mRNA:0.93,0.767,0.917,0.784和0.849,CEA:0.907,0.535,0.852,0.661和0.721,CA19-9:1.0,0.581,1.0,70.5和0.791,CA12-5:0.302,0.814,0.538,0.619和0.558。结论在诊断恶性腹腔积液方面4个指标中CEA mRNA的价值最高,CA12-5的价值最低,CEA mRNA和CA19-9联检可以进一步提高诊断敏感性。