肿瘤M2型丙酮酸激酶检测在良性、恶性胸腔积液诊断中的价值

目的通过检测胸腔积液中肿瘤M2型丙酮酸激酶(M2-PK)水平,探讨肿瘤M2-PK对良性、恶性胸腔积液的鉴别诊断价值。方法收集胸腔积液患者120例,按照类型分为良性胸腔积液组和恶性胸腔积液组。采用ELISA法测定2组胸腔积液中肿瘤M2-PK的浓度。结果肿瘤M2-PK在恶性胸腔积液组浓度为(35.19±2.91)IU/mL,良性胸腔积液组为(11.38±1.02)IU/mL,2组比较有显著性差异(P<0.01)。肺癌患者M2-PK的表达水平在鳞癌、腺癌和小细胞癌中无显著性差异,Ⅲ、Ⅳ期患者血浆中M2-PK水平显著高于Ⅰ、Ⅱ期(P均<0.05)。肿瘤M2-PK诊断恶性胸腔积液的敏感性为88%,准确性为89%,高于CEA和CA199。结论检测胸腔积液中肿瘤M2-PK浓度对鉴别良、恶性胸腔积液有较大价值,值得在临床推广应用。

Value of tumor type M2 pyruvate kinase in differential diagnosis of pleural effusion

Objective It is to approach the value of tumor M2-PK for the differential diagnosis of benign and malignant pleural effusion by detecting pleural effusion tumor M2 pyruvate kinase(M2-PK) level.Methods 120 patients with pleural effusion were selected,including 60 cases of benign pleural effusion and 60 cases of malignant pleural effusion.The level of tumor M2-PK in pleural effusion for all patients was determined by ELISA.Results The concentration of tumor M2-PK was(35.19±2.91) IU/mL in malignant pleural effusion and(11.38±1.02) IU/mL in benign pleural effusion,there was significant difference(P<0.01).For the levels of M2-PK,there were no significant differences between squamous cell carcinoma,adenocarcinoma and small cell carcinoma,but the levels in plasma of patients with grade Ⅲ and Ⅳ were significantly higher than which with grade I and II(all P<0.05).For diagnosis of malignant pleural effusions by tumor M2-PK,the sensitivity was 88%,accuracy 89%,and they were higher than that of CEA and CA199.Conclusion The detection of tumor M2-PK has major value in differentiating benign from malignant pleural effusions,it is worth for clinical application.