[Carcinoembryonic antigen (CEA) in ascites].

Area of Science:

• Oncology
• Gastroenterology
• Clinical Diagnostics

Context:

• Ascites is a common clinical condition with diverse etiologies, including malignancy and benign conditions.
• Accurate differentiation between malignant and benign ascites is crucial for appropriate patient management and treatment.
• Carcinoembryonic antigen (CEA) is a tumor marker often evaluated in various cancers, but its utility in ascites requires specific investigation.

Purpose:

• To prospectively evaluate the diagnostic performance of carcinoembryonic antigen (CEA) in ascites fluid for differentiating malignant from benign ascites.
• To compare the diagnostic accuracy of CEA in ascites fluid versus serum, particularly in patients with liver cirrhosis.

Summary:

• A prospective study involving 18 patients with malignant ascites and 28 with benign ascites assessed the diagnostic value of CEA.
• CEA determination in ascites fluid demonstrated a sensitivity and specificity of 83%, with positive and negative predictive values of 75% and 89%, respectively.
• False-positive CEA results were significantly lower in ascites fluid (17.3%) compared to serum (48.3%) in patients with liver cirrhosis.

Impact:

• The findings suggest that CEA measurement in ascites fluid is a valuable tool for diagnosing malignant ascites.
• Testing CEA in ascites fluid offers improved diagnostic accuracy and reduced false positives compared to serum testing, especially in cirrhotic patients.
• This study recommends the direct analysis of CEA in ascites fluid for enhanced diagnostic precision in patients presenting with ascites.