本文選題：腹水 + MSCT��； 參考：《山西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的探討MSCT掃描與聯(lián)合血清腫瘤標(biāo)志物（CAE及CA199）檢測二者聯(lián)合應(yīng)用對良惡性腹水的臨床診斷價值。資料與方法回顧性分析腹水患者120例，全部病例均經(jīng)病理證實(shí)或隨訪病情好轉(zhuǎn)，對120例腹水患者行MSCT檢查和外周血清腫瘤標(biāo)志物CEA及CA19-9檢測，血清腫瘤標(biāo)志物采用化學(xué)發(fā)光免疫檢測技術(shù)測定，對其結(jié)果進(jìn)行回顧性分析。結(jié)果（1）良性腹水患者發(fā)病年齡較輕，多在50±3.46歲以下，惡性腹水患者發(fā)病年齡多在60±5.21歲以上；（2）良性腹水MSCT表現(xiàn)主要為腹膜均勻光滑性增厚，大網(wǎng)膜或腸系膜呈污跡狀增厚、細(xì)線狀影，當(dāng)患者出現(xiàn)大量腹水時，小腸腸管呈漂浮征象；（3）惡性腹水MSCT主要表現(xiàn)為腹膜不均勻結(jié)節(jié)狀增厚，大網(wǎng)膜或腸系膜餅狀增厚，當(dāng)患者出現(xiàn)大量腹水時，小腸腸管呈聚集征象；（4）腹水的CT征象與血清腫瘤標(biāo)志物CEA及CA199有一定的相關(guān)性：（5）MSCT、血清腫瘤標(biāo)志物CEA、CA19-9診斷良惡性腹水的敏感性54.0%、58.0%、62.0%，，特異性72.8%、61.4%、68.5%，準(zhǔn)確性65.8%、60.0%、65.8%：（6）MSCT與血清腫瘤標(biāo)志物CEA、CA19-9檢測聯(lián)二者聯(lián)合應(yīng)用診斷良惡性腹水的敏感性、特異性及準(zhǔn)確性分別為68%、74.2%及71.7%。（7）MSCT與血清腫瘤標(biāo)志物檢測二者聯(lián)合應(yīng)用，較MSCT單獨(dú)使用，差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論（1）良惡性腹水的MSCT表現(xiàn)有一定的特點(diǎn)，且與血清腫瘤標(biāo)記物有一定的相關(guān)性;(2)MSCT與血清腫瘤標(biāo)志物單獨(dú)檢測對良惡性腹水的診斷有一定的臨床價值；（3）MSCT與血清腫瘤標(biāo)志物檢測二者聯(lián)合應(yīng)用，可以提高對良惡性腹水敏感性及準(zhǔn)確性的診斷，具有較高的臨床應(yīng)用價值。
[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 鹵3.46 years old, and the patients with malignant ascites were more than 60 鹵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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R816.5

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