Gerbes A L, Hoermann R, Mann K, Jüngst D
Department of Medicine II, Klinikum Grosshadern, University of Munich, Germany.
Digestion. 1996;57(2):113-7. doi: 10.1159/000201324.
The clinical value of the tumor marker human chorionic gonadotropin-beta (hCG-beta) in ascitic fluid for the differentiation of malignancy-related and non-malignant ascites was evaluated. Ascitic fluid protein, cholesterol and cytological examination were determined for comparison. Thirty-six patients with malignancy-related ascites (27 peritoneal carcinomatosis, 9 miscellaneous malignant causes without peritoneal carcinomatosis) and 69 patients with nonmalignant ascites (55 with liver cirrhosis, 14 with miscellaneous nonmalignant causes) were investigated. hCG-beta concentrations were elevated in malignant samples and with a cut-off value of 10 mIU/ml hCG-beta yielded a sensitivity of 61%, specificity of 94% and efficiency of 83%. Ascitic fluid protein (cut-off value 3.0 g/100 ml) and cholesterol (cut-off value 45 mg/100 ml) concentrations showed a sensitivity of 64%/83%, specificity of 77%/81% and efficiency of 72%/82%. The combination of hCG-beta and cytological examination yielded 89.5% differential diagnostic efficiency, superior to the combinations of protein and cytology or protein and hCG-beta. hCG-beta tended to be superior to protein/cholesterol determination regarding sensitivity (44% vs. 11%/33%) and specificity (79% vs. 50%/57%) in the subgroups of patients with miscellaneous causes of ascites. In conclusion, hCG-beta is frequently elevated in malignancy-related ascites and seems to be as useful a parameter as total protein for the differentiation of malignancy-related from nonmalignant ascites.
评估了肿瘤标志物人绒毛膜促性腺激素β（hCG-β）在腹水中对鉴别恶性肿瘤相关性腹水和非恶性腹水的临床价值。测定了腹水蛋白、胆固醇并进行了细胞学检查以作比较。对36例恶性肿瘤相关性腹水患者（27例腹膜癌，9例其他恶性病因但无腹膜癌）和69例非恶性腹水患者（55例肝硬化，14例其他非恶性病因）进行了研究。恶性样本中hCG-β浓度升高，以10 mIU/ml为临界值时，hCG-β的敏感性为61%，特异性为94%，效率为83%。腹水蛋白（临界值3.0 g/100 ml）和胆固醇（临界值45 mg/100 ml）浓度的敏感性分别为64%/83%，特异性分别为77%/81%，效率分别为72%/82%。hCG-β与细胞学检查联合应用的鉴别诊断效率为89.5%，优于蛋白与细胞学或蛋白与hCG-β的联合应用。在其他病因所致腹水的亚组中，hCG-β在敏感性（44%对11%/33%）和特异性（79%对50%/57%）方面往往优于蛋白/胆固醇测定。总之，hCG-β在恶性肿瘤相关性腹水中常升高，似乎是区分恶性肿瘤相关性腹水和非恶性腹水的一个与总蛋白同样有用的参数。
