【摘要】 目的 了解分别或联合检测腹腔积液中血管内皮生长因子(VEGF)、糖类抗原199(CA199)和CA125对良、恶性腹腔积液的鉴别诊断价值，提高对腹腔积液的诊断水平。方法 收集各种类型腹腔积液共58例，采用酶联免疫吸附法检测VEGF含量，电化学发光法检测CA199、CA125含量。计算各指标独立或联合鉴别诊断腹腔积液的敏感性、特异性和准确性。结果 恶性腹腔积液组VEGF、CA199、CA125含量明显高于良性腹腔积液组(P均<0.01)，结核性腹腔积液组CA125含量高于肝硬化腹腔积液组(P<0.01)。卵巢癌患者的腹腔积液中VEGF、CA125水平高于胃癌、结肠癌和胰腺癌(P均<0.05)，胰腺癌患者腹腔积液中CA199水平高于另外3类，但无明显差异(P>0.05)。VEGF诊断恶性腹腔积液的敏感性、特异性和准确性分别为84.6%、84.4%和84.5%; CA199的敏感性、特异性和准确性分别为61.5%、78.1%、70.7%;CA125的敏感性、特异性和准确性分别为69.2%、56.3%、62.1%;而联合检测VEGF、CA199和CA125的敏感性、特异性和准确性分别为92.3%、81.3%、86.2%,其中敏感性明显高于单独检测CA199(P<0.01)或CA125(P<0.01)。结论 腹腔积液中VEGF、CA199、CA125测定有助于良恶性腹腔积液的鉴别诊断;恶性腹腔积液中VEGF、CA125的含量对恶性腹腔积液的组织来源可能有一定的鉴别诊断作用;联合检测腹腔积液中的VEGF、CA199、CA125水平，可明显提高诊断恶性腹腔积液的敏感性。
【关键词】 腹腔积液;血管内皮生长因子;糖类抗原199;糖类抗原125;鉴别诊断
The value of combined detections of VEGF, CA199 and CA125 in differential
diagnosis between benign and malignant ascites
SUN Hong1, YAO Hongwei2*
(1. Department of Gastroenterology, People′s Hospital of Suining County, Xuzhou, Jiangsu 221200, China;
2. Medical Department, Changzhou Cancer Hospital, Changzhou, Jiangsu 213164)
Abstract：Objective To investigate the value of individual or combined detections of vascular endothelial growth factor (VEGF), CA199 and CA125 in differential diagnosis between benign and malignant ascites, so as to elevate the levels of ascites diagnosis.Methods 58 cases of various ascites were collected. VEGF levels were detected by enzyme-linked immunosorbent assay (ELISA) and contents of CA199 and CA125 were determined by electrochemiluminescence method. The sensitivity, specificity and accuracy of individual or combined detections of VEGF, CA199 and CA125 in differential diagnosis were calculated.Results The levels of VEGF, CA199 and CA125 in malignant ascites were significantly higher than benign ascites (P<0.01). The CA125 levels in tuberculous ascites group were significantly higher than cirrhotic ascites group (P<0.
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