腹腔积液和血清肿瘤标志物（CA 72-4、CA 19-9、CEA 和 CA 125）水平在鉴别腹腔积液病因中的作用：一项前瞻性研究。

ASCITIC AND SERUM LEVELS OF TUMOR BIOMARKERS (CA 72-4, CA 19-9, CEA AND CA 125) IN DISCRIMINATION OF CAUSE OF ASCITES: A PROSPECTIVE STUDY.

机构信息

Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Arq Gastroenterol. 2022 Apr-Jun;59(2):198-203. doi: 10.1590/S0004-2803.202202000-37.

DOI:10.1590/S0004-2803.202202000-37

PMID:35830029

Abstract

BACKGROUND

The role of ascitic and serum levels of various tumour biomarkers in the discrimination of cause of ascites is not well established.

OBJECTIVE

To evaluate the role of serum and ascitic levels of tumor biomarkers (CA 72-4, CA 19-9, CEA and CA 125) in discrimination of cause of ascites.

METHODS

A prospective study was conducted in consecutive patients presenting with ascites. Serum and ascitic levels of CA 19-9, CA 125, CA 72-4 and carcinoembryonic antigen (CEA) were determined at the presentation. The patients with cirrhotic ascites, tuberculous peritonitis (TBP) and peritoneal carcinomatosis (PC) were eventually included in analysis.

RESULTS

Of the 93 patients (58 males, mean age 47 years) included, the underlying cause was cirrhosis in 31, PC in 42 and peritoneal tuberculosis in 20. The best cutoff for discriminating benign and malignant ascites for serum CEA, CA 19-9 and CA 72-4 were 6.7 ng/mL, 108 IU/mL and 8.9 IU/mL, respectively. The best cutoff for discriminating benign and malignant ascites for ascitic CA 125, CEA, CA 19-9 and CA 72-4 were 623 IU/mL, 8.7 ng/mL, 33.2 IU/mL and 7 IU/mL, respectively.

CONCLUSION

The performance of single biomarker for the prediction of underlying PC is low but a combination of serum CA 19-9 and CA 72-4 best predicted the presence of peritoneal carcinomatosis.

摘要

背景

各种肿瘤标志物的腹水和血清水平在鉴别腹水病因中的作用尚未得到充分证实。

目的

评估血清和腹水肿瘤标志物（CA 72-4、CA 19-9、CEA 和 CA 125）水平在鉴别腹水病因中的作用。

方法

对连续出现腹水的患者进行前瞻性研究。在就诊时测定 CA 19-9、CA 125、CA 72-4 和癌胚抗原（CEA）的血清和腹水水平。最终将肝硬化性腹水、结核性腹膜炎（TBP）和腹膜癌病（PC）患者纳入分析。

结果

93 例患者（58 例男性，平均年龄 47 岁）中，基础病因分别为肝硬化 31 例、PC 42 例和结核性腹膜炎 20 例。鉴别良性和恶性腹水的血清 CEA、CA 19-9 和 CA 72-4 的最佳截断值分别为 6.7ng/mL、108IU/mL 和 8.9IU/mL。鉴别良性和恶性腹水的腹水 CA 125、CEA、CA 19-9 和 CA 72-4 的最佳截断值分别为 623IU/mL、8.7ng/mL、33.2IU/mL 和 7IU/mL。