Premium
Clinical value of tumour markers and serum‐ascites albumin gradient in the diagnosis of malignancy‐related ascites
Author(s) -
CHEN SHENJYH,
WANG SUNSANG,
LU CHIWEN,
CHAO YEE,
LEE FAYAUH,
LEE SHOUDONG,
WU SHWULING,
CHERNG KULI,
LO KWANGJUEI
Publication year - 1994
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1994.tb01262.x
Subject(s) - ascites , carcinoembryonic antigen , medicine , malignancy , albumin , gastroenterology , hepatocellular carcinoma , pathology , cancer
To determine the clinical value of tumour markers in the diagnosis of malignancy‐related ascites (not including hepatocellular carcinoma), serum and ascitic fluid levels of carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 19–9, tissue polypeptide antigen and serum‐ascites albumin gradient were determined in 66 patients with cirrhotic ascites, 28 patients with hepatocellular carcinoma and ascites, and 29 patients with malignancy‐related ascites. Three tumour markers and serum‐ascites albumin gradient showed significant difference between patients with malignancy‐related ascites and those without: serum carcinoembryonic antigen (26.4 ± 31.5 vs 4.8 ± 4.6 ng/mL, P < 0.01), ascitic fluid carcinoembryonic antigen (118.4 ± 196.5 vs 2.0 ± 1.4 ng/mL, P < 0.01), ascitic fluid carbohydrate antigen 19–9 (12 933 ± 25 496 vs 23 ± 67 U/mL, P < 0.01), and serum‐ascites albumin gradient (1.1 ± 0.4 vs 2.0 ± 0.4 g/dL, P < 0.01). At the best cut‐off levels chosen from near 95% of the data in those without malignancy‐related ascites, the sensitivity, specificity and accuracy to diagnose malignancy‐related ascites were, respectively, 65.5%, 93.6%, 87.0% using serum carcinoembryonic antigen 10 ng/mL; 69.0%, 94.7%, 88.6% using ascitic fluid carcinoembryonic antigen 5 ng/mL; 65.5%, 93.6%, 87.0% using ascitic fluid carbohydrate antigen 19–9 50 U/mL; 62.1%, 98.9%, 90.2% using serum‐ascites albumin gradient < 1.1 g/dL. Although serum‐ascites albumin gradient offered the best diagnostic accuracy and specificity, its sensitivity was not good enough. Our study indicates that serum‐ascites albumin gradient and tumour markers are not sensitive parameters in the diagnosis of malignancy‐related ascites.