Differential Diagnostic Value Of Simultaneous Determination Of Tumor Markers In Ascitic Fluid And Serum And Their Ratios For Differentiation Of Benign From Malignant Ascites

Objective:To evaluate the clinical diagnostic value of simultaneous determination of tumor markers in fluid and serum and their ratio (F/S) to patients with benign or malignant ascites.Methods:Retrospectiveanalysis the concentrations of tumor markers AFP, CEA, CA19-9, CA125 in fluid and serum and their ratio from 95 patients with ascites due to various causes (malignant 52, benign 43).Results:1.The levels of ascitic fluid CEA,CA19-9,CA125 and the blood serum AFP,CEA,CA19-9 in patients with malignant ascites were significantly higher than those in patients with benign ascites(P <0.001).The fluid AFP and serum CA125 had no difference between patients with malignant and benign ascites(P>0.05).2.Let the highest concentration of tumor markers in serum or the biggest F/S ratio be the upper limit(the specificity was 100%).There was no different diagnostic sensitivity between the fluid AFP, CEA, CA19-9 and their F/S ratios(P>0.05). The diagnostic sensitivity of fluid CA125 was higher than its F/S ratio (P<0.01).3.According to the ROC curve, the under-curve area of fluid AFP, CEA, CA19-9 and CA125 were 0.510,0.825,0.773 and 0.500.It showed that CEA and CA19-9 could be used for differential diagnosis between malignant and benign ascites. AFP had a little differential diagnostic value and CA125 had no value.4.The sensitivity, specificity and diagnostic accuracy of fluid CEA were 67.3%,95.3% and 80.0%. The sensitivity, specificity and diagnostic accuracy of fluid CA19-9 were 61.5%,93.0% and 75.8%. The sensitivity, specificity and diagnostic accuracy of the combined detection of the two tumor markers were 78.8%,90.7% and 84.2%. The sensitivity, specificity and diagnostic accuracy of the combined detection of these two tumor markers and their F/S ratios were 94.2%, 90.7% and 92.6%.The diagnostic sensitivity and accuracy were obviously improved (P<0.01).Conclusions:The fluid CEA and CA19-9 were more valuable than AFP for differentiation of benign from malignant ascites, CA125 had no value for differentiation of benign from malignant ascites. The diagnostic sensitivity and accuracy could be significantly increased by simultaneous determination of the concentration of CEA, CA19-9 in fluid and their F/S ratio.