title: Diagnostic value of carcinoembryonic antigen in malignancy-related ascites: systematic review and meta-analysis.
abstract: OBJECTIVE
  There is a common misconception that malignant ascites is equivalent to peritoneal carcinomatosis. It seems that malignancy-related ascites is a more appropriate description of malignant ascites, which is difficult to confirm. Carcinoembryonic antigen, a glycoprotein tumor marker shed by malignant cells, increases in a wide range of gastrointestinal malignancies. We carried out the current meta-analysis to determine carcinoembryonic antigen accuracy in the diagnosis of malignancy-related ascites.
  
  
  METHODS
  Pubmed/Medline and SCOPUS were searched using these search terms: malignan* AND ascites AND (CEA OR carcinoembryonic). The outcome of interest was carcino-embryonic antigen accuracy in the differentiation of malignancy-related ascites and nonmalignant ascites.
  
  
  RESULTS
  Seven studies were included in this systematic review. Pooled diagnostic indices using random-effects model were as follows: sensitivity 43.1% [381-48.3]; specificity 95.5% [93-97.3]; LR+ (positive likelihood ratio) 7.33 [4.58-11.73]; LR- (negative likelihood ratio) 0.6 [0.54-0.68]; and DOR (diagnostic odds ratio) 12.93 [7.58-22].
  
  
  CONCLUSIONS
  Carcinoembryonic antigen of the ascitic fluid does not seem to be sensitive enough to diagnose malignancy-related ascites. However, due to high specificity, the positive predictive value of this marker is high and the higher the level of carcino-embryonic antigen, the more likely it is to be malignancy-related. Nevertheless, a negative test result cannot definitely rule out the malignancy.
authors: Mitra
authors: M
authors: Ahadi
authors: Shahrzad
authors: S
authors: Tehranian
authors: Bahram
authors: B
authors: Memar
authors: Hassan
authors: H
authors: Vossoughinia
authors: Masoumeh
authors: M
authors: Salari
authors: Elaheh
authors: E
authors: Eskandari
authors: Mohammadreza
authors: M
authors: Farzanehfar
authors: Ramin
authors: R
authors: Sadeghi
mesh_terms: D001201:Ascites / Q000175:diagnosis* / Q000378:metabolism; D001202:Ascitic Fluid / Q000378:metabolism*; D002272:Carcinoembryonic Antigen / Q000378:metabolism*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000378:metabolism
chemical_list: D002272:Carcinoembryonic Antigen