胸腺嘧啶核苷激酶检测对良恶性胸腔积液的诊断价值

目的通过检测良恶性胸腔积液中TK1（Thymidine Kinase 1,细胞质胸腺嘧啶核苷激酶）的浓度并与当前常用的实验室诊断方法相比较,探讨TK1在胸腔积液性质诊断中的临床应用价值。方法收集50例恶性胸腔积液（MPE）患者和55例非恶性胸腔积液患者的积液和血清样本。以电化学免疫发光法测定TK1、CEA（癌胚抗原）浓度,连续监测法测定LDH（乳酸脱氢酶）浓度,通过Mann-Whitney U检验和Kruskal-Wallis H检验进行组间比较,并以受试者工作曲线评估诊断价值。结果取截断值为4.07μmol.L-1和5.43μg.L-1时,积液中TK1、积液中CEA浓度诊断恶性胸腔积液的灵敏度和特异度分别为90%和84%、68%和95%。检测积液中TK1浓度诊断MPEs的灵敏度较检测CEA高,但在特异性和原发肿瘤病理类型的鉴别方面不及CEA。结论 TK1作为一种新的鉴别良恶性胸腔积液的高灵敏度的标志物,具有一定的应用前景。

Clinical significance of TK1 expressions in the differential diagnosis of malignant and benign pleural effusions

Objective To compare the efficacy of thymidine kinase 1,a novel tumor marker,with ordinary markers in diagnosis of malignant and benign pleural effusions.Methods 105 patients were screened in the study,a roc curve was enrolled in the comparison of diagnosis efficacy.Results Pleural TK1 had the same AUC（area under curve）as pleural CEA.The sensitivity and specificity of pleural TK1 was 90% and 84%,while pleural CEA was 68% and 94%.Conclusion Pleural TK1 can be used as a novel marker for diagnosis of MPEs.