The Value Of Multi-tumor Markers Protein Chip Diagnosis System In The Differential Diagnosis Of Benign And Malignant Effusion In Pleural Effusions Or Ascites

Background: Pleural effusions or ascites is common symptom in clinic. It is a very important work how to identify the characteristic of pleural effusions or ascites. Routine detections such as biochemistry,cytology or single tumor marker in pleural effusions or ascites are always not been satisfied for clinic because of their shortcomings. There had many articles to talk about the value of tumor markers in serum detected by C12 system, but few were reported in pleural effusions or ascites.Objective: To know more about the reliability and validity of C12 system diagnosis differentially for pleural effusions or ascites, to setup new combinations of tumor markers to identify preferably its benign or malignant characteristic, and discuss the significance in different tumors.Methods: A survey was performed to patients who had moderately or great quantity of pleural effusions or ascites when visiting in each department of the First Affiliated Hospital of Anhui Medical University from October 2006 to August 2007. The malignant evidence was confirmed by pathology or cytology. While it was not confirmed, the patients would be followed up for half year. Self-administered questionnaire containing demography and cancer characteristics were used to analyze the influencing factors. The levels of twelve tumor markers in pleural effusions or ascites were measured by C12 system. Chi-square test was applied to analyze the value of different combination for positive tumor markers in benign and malignant pleural effusions group,benign and malignant ascites group respectively. The C12 diagnosis system were evaluated respectively in sensitivity,specificity,positive or negative predictive value and accuracy of diagnosis in the benign group, the malignant group and unknown group. The diagnostic value of protein chip system was compared with the cytology. A valuable combination of tumor markers detection was set up in different tumors.Results: A total of 128 cases were enrolled. All the cases were confirmed by pathology or cytology. 54 patients were in benign group, 60 patients in malignant group, and 14 patients in unknown group. The levels of CEA,Ferritin,CA15-3 and CA125 in malignant pleural effusions group were remarkably higher than in benign group (χ2=11.786, P < 0.01) . The levels of CEA,Ferritin,CA19-9,CA242 and CA125 in malignant ascites group were remarkably higher than in benign group (χ2=16.427, P < 0.005) . C12 system had coincident rate about 83.78%,84.18%,82.17% when the result of cytology was positive,negative and ambiguous respectively. The diagnostic effectivity of single tumor marker in malignant pleural effusions or ascites was 70.31%, while multi-tumor markers combination was 90.47%. The results indicated that the combined detection system would improve diagnostic specificity while comparing with single tumor marker detection, although the diagnostic sensitivity was decreased in some tumors.Conclusion: Combined multi-tumor markers detection was prior to single tumor marker detection in the way of high speed,high sensitivity,high specificity,high throughput. It would help to improve the diagnostic rate of pleural effusions or ascites and further to confirm the primary lesions. It can be stepwise used in clinic as a new diagnostic method for pleural effusion or ascites.