胸苷激酶1对恶性肿瘤的早期诊断价值

目的探讨胸苷激酶1（thymidine kinase1，TK1）在恶性肿瘤早期诊断中的价值。方法选择健康体检组465例、对照组43例、良性增生组39例、恶性肿瘤组37例、癌前病变组34例作为受试对象．采用点印迹免疫酶化学发光法检测TK1水平，采用微粒子发光法检测传统肿瘤标志物CEA、AFP、CA199、CA153、CA125水平，并进行统计学分析。结果各组间血清TK1、CEA、AFP、CA199、CA153、CA125检测水平差异均有统计学意义（P均〈0．01）。对照组与恶性肿瘤组比较，各指标检测水平差异均有统计学意义（P均〈0.01），与良性增生组比较，各指标检测水平差异均无统计学意义（P均〉0．05），与癌前病变组比较，除TK1（P〈0．01）外，其余各指标检测水平差异均无统计学意义（P均〉0．05）；恶性肿瘤组分别与良性增生组及癌前病变组比较，各指标检测水平差异均有统计学意义（P均〈0．01），良性增生组与癌前病变组比较，除TK1（P〈0．01）外，其余各指标检测水平差异均无统计学意义（P均〉0．05）。受试者工作特征曲线分析，TK1对于恶性肿瘤的诊断敏感度为93．1％，特异性为73.3％，曲线下面积为0．90；465例健康体检者中早期发现恶性肿瘤2例，均尚无临床症状及影像学改变。结论血清TK1检测对于恶性肿瘤的早期诊断具有重要诊断价值。

Assess the earlier diagnostic value of thymidine kinase I on malignant tumors

Objective To assess the earlier diagnostic value of thymidine kinase 1 （TK1） on malignant tumors. Methods 465 cases healthy check-up, 43 cases control, 39 cases benign hyperplasia, 37 cases malignant tumors and 34 cases precancerous lesions were collected. The levels of TK1 were detected by enhanced chemoluminescence dot blot assay,and the levels of serum tumor markers （CEA, AFP, CA199, CA153, CA125 ） were detected by particles chemiluminescence method and the results were analyzed statistically. Results There were statistical significance in the differences of TK1, CEA, AFP, CA199, CA153, CA125 levels among all the groups （Pall〈 0.01 ）. The levels of all markers in malignant tumors group were all higher than in control group, and the differences all had statistical significance （Pall〈 0.01 ）. There was no sta- tistical significance in the differences of all markers between benign hyperplasia group and control group （Pall〉 0.05） ; Contrast to control group, the levels of tumor markers in precancerous lesions group shown no statistical difference （Pall〉 0.05） except TK1 （P〈 0.01 ）. The levels of all markers in malignant tumors group were all higher than in benign hyperplasia group and precancerous lesions group, and the differences all had statistical significance （Pall〈 0.01 ）. Contrast to benign hyperplasia group, the levels of all markers in precancerous lesions group shown no statistical difference （Pall〉 0.05 ） except TK1 （P〈 0.01 ）. Diagnostic sensitivity and speci- ficity of TK1 to malignant tumors were 93.1% and 73.3% by receiver operating characteristic curve and the area under curve was 0.90. Two cases of malignant tumors were found among 465 cases healthy check-up, without clinical symptoms and imaging radiculopathy. Conclusion Serum TK1 has significant early diagnostic value on malignant tumors.