比较两种方法在解读腹腔积液中肿瘤标志物的效果。
Comparative Assessment of Two Strategies for Interpreting Tumor Markers in Ascitic Effusions.
机构信息
Department of Laboratory Medicine, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
Facultat de Medicina, Universitat de Vic, Universitat Central de Catalunya, Vic, Spain.
出版信息
In Vivo. 2020 Mar-Apr;34(2):715-722. doi: 10.21873/invivo.11829.
BACKGROUND/AIM: There are two strategies for the interpretation of tumor markers (TM) in fluid effusions: i) high cut-off and ii) fluid/serum ratio (F/S) and low cut-off. The objective of this study is to compare these two strategies and to determine whether diagnostic accuracy improves by the identification of possible false positives using Adenosine deaminase (ADA), C reactive protein (CRP) and % of polymorphonuclear cells (%PN).
PATIENTS AND METHODS
We studied 157 ascitic fluids, 74 of which were malignant. ADA, CRP and %PN were determined in ascitic fluid, and Carcinoembryonic antigen (CEA), Cancer antigen 72-4 (CA72-4), Cancer antigen CA19-9 and Cancer antigen 15-3 (CA15-3) in both fluid and serum.
RESULTS
The strategy of high cut-off showed 59.5% sensitivity at 100% specificity. The F/S strategy showed 75.7% sensitivity at 95.2% specificity. Subclassifying cases with ADA, CRP and %PN negative showed 67.5% sensitivity at 100% specificity for high cut-off and for the F/S strategy was 81.7% sensitivity at 98.7% specificity.
CONCLUSION
The strategy of F/S with negative ADA, CRP and %PN allow the best interpretation for TM in the ascitic fluid.
背景/目的：在体液中肿瘤标志物（TM）的解释有两种策略：i）高截断值和 ii）液体/血清比值（F/S）和低截断值。本研究的目的是比较这两种策略，并通过鉴定可能的假阳性（使用腺苷脱氨酶（ADA）、C 反应蛋白（CRP）和中性粒细胞百分比（%PN））来确定诊断准确性是否提高。
患者和方法
我们研究了 157 份腹水，其中 74 份为恶性。在腹水和血清中测定 ADA、CRP 和 %PN，在液体和血清中测定癌胚抗原（CEA）、癌症抗原 72-4（CA72-4）、癌症抗原 CA19-9 和癌症抗原 15-3（CA15-3）。
结果
高截断值策略的敏感性为 59.5%，特异性为 100%。F/S 策略的敏感性为 75.7%，特异性为 95.2%。将 ADA、CRP 和 %PN 阴性的病例进行亚分类，高截断值策略的敏感性为 67.5%，特异性为 100%，F/S 策略的敏感性为 81.7%，特异性为 98.7%。
结论
ADA、CRP 和 %PN 阴性的 F/S 策略最适合解释腹水的 TM。
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