- 期刊
結核性腹膜炎與腹膜轉移癌臨床表徵及一般性檢查之差異
The Difference in Clinical and Conventional Laboratory Features between Tuberculous Peritonitis and Peritoneal Carcinomatosis
摘要
The difference in the clinical and conventional laboratoiy features between tuberculous peritonitis and peritoneal carcinomatosis was retrospectively analysed in 25 patients with tuberculous peritonitis, and 58 patients with peritoneal carcinomatosis proved by peritoneoscopic and histopathological examination, from Jan. 1985 to Dec. 1990. The clinical features revealed no significant difference except that fever Was mucr more prevalent in tuberculous peritonitis than in peritoneal carcinomatosis (64% vs 12%, P＜0.005). Chest X-ray suggestive of pulmonary tuberculosis was found in 28% of patients was tuberculous peritonitis, but in only 3% of patients with peritoneal carcinomatosis (P＜0.05). Serum albumin was lower (2.7±0.68gmn/dL vs 3.1±0.53gm/dL, P＜0.05) but globulin higher (4.1±0.77gm/dL vs 3.1±0.67gm/dL, P＜0.005) in tuberculous peritonitis than in peritoneal carcinomatosis. Fourteen (56%) of25 patients with tuberculous peritonitis, and only 3 (5%) of 58 patients with peritoneal carcinomatosis, had a serum globulin-albumin gradient higher than 1.3gm/dL (P＜0.005). Other laboratory data, such as WBC & its classification, RBC, ESR, ALT, and Alk-P, showed no significant difference. Serum CEA was elevated (＞4ng/ml) in 50% (20/40) of patients with peritoneal carcinonwtosis but only in 6% (1/16) of patients with tuberculous peritonitis (P＜0.05). The result of ascites examination, including WBC & its classification, RBC, sugar, LDH, lactate, and total protein showed no significant difference. Ascites cytology was positive in 44% (22/50) of patients with peritoneal carcinomatosis, and culture of tuberculous bacilli was positive in 4.3% (1/23) of patients with tuberculous peritonitis. In conculsion, the clinical and laboratory features of tuberoulous peritonitis and peritoneal carcinomatosis often overlapped, but a history of fever, serum albumin, globulin, globulin-albumin gradient (＞1.3gm/dL), CEA, and chest X-ray examination might help in their initial differential diagnosis.
並列摘要
The difference in the clinical and conventional laboratoiy features between tuberculous peritonitis and peritoneal carcinomatosis was retrospectively analysed in 25 patients with tuberculous peritonitis, and 58 patients with peritoneal carcinomatosis proved by peritoneoscopic and histopathological examination, from Jan. 1985 to Dec. 1990. The clinical features revealed no significant difference except that fever Was mucr more prevalent in tuberculous peritonitis than in peritoneal carcinomatosis (64% vs 12%, P＜0.005). Chest X-ray suggestive of pulmonary tuberculosis was found in 28% of patients was tuberculous peritonitis, but in only 3% of patients with peritoneal carcinomatosis (P＜0.05). Serum albumin was lower (2.7±0.68gmn/dL vs 3.1±0.53gm/dL, P＜0.05) but globulin higher (4.1±0.77gm/dL vs 3.1±0.67gm/dL, P＜0.005) in tuberculous peritonitis than in peritoneal carcinomatosis. Fourteen (56%) of25 patients with tuberculous peritonitis, and only 3 (5%) of 58 patients with peritoneal carcinomatosis, had a serum globulin-albumin gradient higher than 1.3gm/dL (P＜0.005). Other laboratory data, such as WBC & its classification, RBC, ESR, ALT, and Alk-P, showed no significant difference. Serum CEA was elevated (＞4ng/ml) in 50% (20/40) of patients with peritoneal carcinonwtosis but only in 6% (1/16) of patients with tuberculous peritonitis (P＜0.05). The result of ascites examination, including WBC & its classification, RBC, sugar, LDH, lactate, and total protein showed no significant difference. Ascites cytology was positive in 44% (22/50) of patients with peritoneal carcinomatosis, and culture of tuberculous bacilli was positive in 4.3% (1/23) of patients with tuberculous peritonitis. In conculsion, the clinical and laboratory features of tuberoulous peritonitis and peritoneal carcinomatosis often overlapped, but a history of fever, serum albumin, globulin, globulin-albumin gradient (＞1.3gm/dL), CEA, and chest X-ray examination might help in their initial differential diagnosis.
延伸閱讀
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