The Value Of Inhibitor Of Apoptosis Protein Survivin And XIAP In The Differential Diagnosis From Benign Ascites To Malignant Ascites

Objective:To evaluate the diagnostic value of Survivin and XIAP in benign and malignant ascites.Methods:The ascites specimens of 31 patients with tumour and 34 patients with benign disease (including 26 patients with cirrhosis and 8 patients with tuberculosis) were investigated. Reverse transcription-Polymerase chain reaction (RT-PCR) was performed to detect the Survivin mRNA and XIAP mRNA expression in the exfoliated cells of ascites.The results were compared with carcinoembryonic antigen (CEA).Results:1. The positive rate of Survivin mRNA in malignant ascites was 61.3%(19/31), but it was not detected in benign ascites, there was obvious defference between two groups (P<0.01).The positive rate of XIAP mRNA in malignant ascites and in benign ascites were 71.0%(22/31) and 14.7%(5/34, including 3 cases of cirrhosis and 2 cases of tuberculosis), there was statistic significance between malignant and benign ascites (P<0.01). However, the positive rate of XIAP mRNA had no obvious defference between cirrhotic and tuberculosis ascites (P>0.05).The positive rate of CEA in malignant ascites was 54.8%(17/31), while there was no benign ascites expressed CEA, the defference was obviously (P<0.01).2. The sensitivity and specificity of Survivin mRNA, XIAP mRNA and CEA were 61.3%,71.0%,54.8% and 100%,85.3%,100%, there were both obvious defference between their sensitivity and specificity (P<0.01). XIAP mRNA was the most sensitive and CEA was the least, Survivin mRNA was medium. But for specificity, XIAP mRNA was lower than Survivin mRNA and CEA.3. Survivin mRNA, XIAP mRNA and CEA did not coincide on their goodness of fit(κ<0.4), and the combination of them were more sencitive.4. No significant correlation was observed between the expression of Survivin mRNA and XIAP mRNA in malignant ascites (P>0.05), they had no relationships with the expression of CEA in malignant ascites too (P> 0.05). 5. The expression strength of Survivin mRNA and XIAP mRNA in malignant ascites had no significant correlation with age, gender, SAAG and the kinds of tumour.Conclusions:Survivin mRNA and XIAP mRNA expressed in exfoliated cells of ascites are two new independent diagnostic markers of practical value for the differential diagnosis of benign and malignant ascites.