Abstract
To evaluate the values of 4 tumor markers in serum and ascites and their ascites/serum ratios in the identification and diagnosis of benign and malignant ascites. A total of 76 patients were selected as subjects and divided into malignant ascites group (45 cases) and benign ascites group (31 cases). Samples of ascites and serum of all hospitalized patients were collected before treatment. The levels of carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), cancer antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were detected by chemiluminescence (CLIA) . CEA, AFP and CA19-9 in both serum and ascites as well as CA125 in ascites were evidently higher in the malignant ascites group than in the benign ascites group (P<0.01). Malignant ascites was associated with elevated ascites/serum ratios for AFP and CA125 (P<0.01). The areas under receiver operating characteristic (AUROCs) of CEA and CA125 in ascites and the ratios of ascites/serum of AFP, CEA, CA125 and CA19-9 were all >0.7, suggesting certain values, while those of ascites CA19-9 and serum CEA were 0.697 and 0.629 respectively, indicating low accuracy in the identification and diagnosis of benign and malignant ascites. However, the AUROCs of the remaining indexes were <0.5, with no value for identification and diagnosis. Compared with single index, the sensitivity of combined detection increased significantly (P<0.05), in which the combined detection of CEA, CA19-9 and CA125 in ascites as well as the ratio of ascites/serum of CEA, CA19-9, CA125 and AFP had the highest sensitivity (98.4%) but with relevantly low specificity. Both sensitivity and specificity of combined detection should be comprehensively considered so as to choose the most appropriate index. Compared with single index, combined detection of tumor markers in serum and ascites can significantly improve the diagnostic sensitivity and specificity.
Highlights
Ascites, as a commonly seen symptom in clinic, is caused by malignant tumors of enterocoelia and peritoneum, hepatic diseases, tuberculous peritonitis, cardiac insufficiency and renal diseases, etc, which can be divided into benign and malignant ones
carcinoembryonic antigen (CEA), alpha fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) in both serum and ascites as well as cancer antigen 125 (CA125) in ascites were higher in the malignant ascites group than in the benign ascites group (P
Malignant ascites was associated with elevated ascites/serum ratios for AFP and CA125 (P
Summary
As a commonly seen symptom in clinic, is caused by malignant tumors of enterocoelia and peritoneum, hepatic diseases, tuberculous peritonitis, cardiac insufficiency and renal diseases, etc, which can be divided into benign and malignant ones. The therapeutic protocols and prognosis of ascites induced by malignant tumors are quite different from those by benign lesions, for which the definition of ascites causes is of great significance. It is still a difficult issue in clinic to distinguish the benign and malignant ascites, especially the early diagnosis of malignant ascites. In the identification and diagnosis of ascites, cytological detection of ascites has become a gold standard for the confirmation of malignant ascites (Liu et al, 2014) Though this detection has high specificity, its sensitivity is low, which can cause missed diagnosis and repeated tests after multiple ascites collections, leading to the delay of the optimal therapeutic opportunity to some extent and the increase of patients’ pain by abdominocentesis. 0.0001 0.0560
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