肿瘤相关物质群检测对颈部肿块鉴别诊断的价值

背景与目的:文献报道,血清的肿瘤相关物质群(tumorsuppliedgroupoffactors,TSGF)对多种良、恶性肿瘤的鉴别诊断有一定的参考价值。但未见涉及颈部肿块鉴别诊断的报道。本文专门探讨血清TSGF对于颈部肿块鉴别诊断的意义。方法:以免疫组化法检测128例颈部肿块患者的血清TSGF,并以47例非肿瘤患者作为对照。结果:不同的恶性肿瘤组(包括鼻咽癌、非霍奇金淋巴瘤和原发部位不明的颈部转移癌)的血清TSGF水平和阳性率均高于良性肿块组(包括颈部淋巴结炎或反应性增生及不伴全身活动性结核的颈部淋巴结结核),差异有非常显著性(均P<0.01);而在2种良性肿块之间,颈良性肿块与非肿瘤患者之间差异均无显著性(P>0.05)。血清TSGF阳性对于颈部恶性肿块的鉴别诊断参数为:敏感性78.16%,特异性75.61%,有效率77.34%,阳性预测值犤PV(+)犦87.18%,阴性预测值犤PV(-)犦62.00%。结论:血清TSGF检测对于鉴别颈部肿块的良、恶性有一定的参考价值。

Significance of detecting serum tumor supplied group of factors in differential diagnosis of neck masses

BACKGROUND & OBJECTIVE: It was reported that serum tumor supplied group of factors (TSGF) were useful in differential diagnosis of various benign and malignant tumor. However, there was little report involving the differential diagnosis of neck masses. This study was designed to evaluate the significance of serum TSGF in differential diagnosis of neck masses. METHOD: Serum TSGFs on the samples from 128 patients with neck masses were detected by immunohistochemistry. Forty seven non-tumor patients served as control. RESULTS: Serum TSGF level and positive rate in various malignant group (including nasopharyngeal carcinoma, non-Hodgkin's disease, and metastatic carcinoma which primary lesion remained unknown) were higher than that in benign mass group (including cervical lymphoadenitis, or reactive hyperplasia, and neck lymphoid tuberculosis without general active tuberculosis), with very significant difference (all P < 0.01). There was no significant difference between two benign masses or neck benjgn masses or neck benign masses and non tumor patients (all P > 0.05). The differential diagnosis parameters of positive serum TSGF for neck malignant masses were: sensitivity 78.16%, specificity 75.61%, efficiency 77.34%, positive predictive value [PV(+)] 87.18%, negative predictive value [PV(-)] 62.00%. CONCLUSION: Determination of serum TSGF was useful in differential diagnosis of neck masses.