MSCT及其联合血清肿瘤标志物在诊断良恶性腹水中的价值

发布时间：2018-05-10 15:01

本文选题：腹水 + MSCT　；参考：《山西医科大学》2013年硕士论文

【摘要】：目的探讨MSCT扫描与联合血清肿瘤标志物（CAE及CA199）检测二者联合应用对良恶性腹水的临床诊断价值。资料与方法回顾性分析腹水患者120例，全部病例均经病理证实或随访病情好转，对120例腹水患者行MSCT检查和外周血清肿瘤标志物CEA及CA19-9检测，血清肿瘤标志物采用化学发光免疫检测技术测定，对其结果进行回顾性分析。结果（1）良性腹水患者发病年龄较轻，多在50±3.46岁以下，恶性腹水患者发病年龄多在60±5.21岁以上；（2）良性腹水MSCT表现主要为腹膜均匀光滑性增厚，大网膜或肠系膜呈污迹状增厚、细线状影，当患者出现大量腹水时，小肠肠管呈漂浮征象；（3）恶性腹水MSCT主要表现为腹膜不均匀结节状增厚，大网膜或肠系膜饼状增厚，当患者出现大量腹水时，小肠肠管呈聚集征象；（4）腹水的CT征象与血清肿瘤标志物CEA及CA199有一定的相关性：（5）MSCT、血清肿瘤标志物CEA、CA19-9诊断良恶性腹水的敏感性54.0%、58.0%、62.0%，，特异性72.8%、61.4%、68.5%，准确性65.8%、60.0%、65.8%：（6）MSCT与血清肿瘤标志物CEA、CA19-9检测联二者联合应用诊断良恶性腹水的敏感性、特异性及准确性分别为68%、74.2%及71.7%。（7）MSCT与血清肿瘤标志物检测二者联合应用，较MSCT单独使用，差异有统计学意义。结论（1）良恶性腹水的MSCT表现有一定的特点，且与血清肿瘤标记物有一定的相关性;(2)MSCT与血清肿瘤标志物单独检测对良恶性腹水的诊断有一定的临床价值；（3）MSCT与血清肿瘤标志物检测二者联合应用，可以提高对良恶性腹水敏感性及准确性的诊断，具有较高的临床应用价值。
[Abstract]:Objective to evaluate the clinical value of MSCT scan combined with serum tumor markers (CAE and CA1999) in the diagnosis of benign and malignant ascites. Materials and methods 120 patients with ascites were retrospectively analyzed. All patients were confirmed by pathology or were followed up. MSCT and CEA and CA19-9 were performed in 120 patients with ascites. Serum tumor markers were determined by chemiluminescence immunoassay and the results were analyzed retrospectively. Results 1) the patients with benign ascites were younger than 50 卤3.46 years old, and the patients with malignant ascites were more than 60 卤5.21 years old. The MSCT manifestations of benign ascites were mainly homogeneous and smooth thickening of peritoneum and thickening of omentum or mesentery. Thin line shadow, when the patient appears a large amount of ascites, the intestinal tract presents a floating sign. The MSCT of malignant ascites is mainly characterized by the inhomogeneous nodular thickening of the peritoneum, the thickening of the omentum or mesenteric cake, and the occurrence of a large amount of ascites in the patient. There was a correlation between CT signs of ascites and serum tumor markers CEA and CA199. The sensitivity of serum tumor marker CEA CA19-9 to diagnosis of benign and malignant ascites was 54.0 and 58.0. The sensitivity was 54.0 and the specificity was 72.81.468.55.68.5. the accuracy was 65.80.065.80.The accuracy was 65.80.0. The sensitivity of combined use of CEA and CA19-9 in the diagnosis of benign and malignant ascites was analyzed. The specificity and accuracy were 68.2% and 74.2%, respectively, and the combined use of 71.7%.(7)MSCT and serum tumor markers was more significant than that of MSCT alone. Conclusion (1) the MSCT findings of benign and malignant ascites have some characteristics. There was a certain correlation between MSCT and serum tumor markers in the diagnosis of benign and malignant ascites. The combination of MSCT and serum tumor markers was used in the diagnosis of benign and malignant ascites. It can improve the sensitivity and accuracy of diagnosis for benign and malignant ascites.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.5

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