浆膜腔积液中组织蛋白酶D与肿瘤转移的关系

目的研究浆膜腔积液中组织蛋白酶D（CD）与肿瘤转移之间的关系。方法分别采用酶联免疫吸附试验（ELISA）和化学发光法检测77例患者的浆膜腔积液CD及癌胚抗原（CEA）浓度。结合临床资料和病理诊断，将77例患者的浆膜腔积液标本分为非肿瘤组（22例）和肿瘤组[55例，包括肿瘤细胞阳性组（30例）和肿瘤细胞阴性组（25例）]。比较各组CD及CEA浓度，同时采用受试者工作特征（ROC）曲线评估CD及CEA单项检测和联合检测的诊断价值。结果肿瘤组CD和CEA浓度均明显高于非肿瘤组（P〈0．05）。CEA与CD呈正相关（Kendall相关系数为0．323、Spearman相关系数为0．396，P均〈0．001），CD、CEA及CEA与CD联合诊断肿瘤的ROC曲线下面积分别为0．763、0．723和0．812。肿瘤细胞阳性组CD浓度明显高于肿瘤细胞阴性组（P〈0．05），而CEA浓度2组间中差异无统计学意义（P=0．051），CD、CEA及CEA与CD联合诊断肿瘤转移的ROC曲线下面积分别为0．677、0．654和0．767。结论浆膜腔CD浓度与肿瘤浆膜腔转移相关，可作为肿瘤诊断和转移的辅助指标，联合CEA诊断更佳。

Relationship between tumor metastasis and cathepsin D in serous cavity effusion

Objective To study the relationship between tUnlOr metastasis and cathepsin D （CD） in serous cavity effusion. Methods A total of 77 patients with serous cavity effusion were enrolled in the study. According to the clinical data and pathological diagnosis, the 77 patients were classified into 2 groups, non-tumor group （22 cases） and tumor group （55 cases, including 30 cases of tumor cell positive group and 25 cases of tumor cell negative group）. The concentrations of CD and carcinoembryonic antigen （CEA） in serous cavity effusion were determined by enzyme-linked immunosorbent assay （ELISA） and chemiluminescence, respectively. The concentrations of CD and CEA from different groups were compared, and the receiver operating characteristic （ROC） curve was used to evaluate the diagnosis significance of CD determination, CEA determination and the combined CD and CEA determination. Results The concentrations of CD and CEA in the tumor group were significantly higher than those in the non-tumor group （ P 〈 0.05 ）. The concentration of CD was positively correlated with that of CEA （Kendall correlation coefficient 0. 323, Spearman correlation coefficient 0. 396, P 〈 0. 001 ）. The areas under the ROC curve of CD, CEA and CEA combined with CD for discriminating tumor were 0. 763,0. 723 and 0. 812, respectively. The concentration of CD in the tumor cell positive group was significantly higher than that in the tumor cell negative group （P 〈 0.05 ）, whereas the concentrations of CEA in the 2 groups were not significantly different （ P = 0.051 ）. The areas under the ROC curve of CD, CEA and CEA combined with CD for discriminating tumor metastasis were 0. 677, 0. 654 and 0. 767, respectively. Conclusions The concentration of CD in serous cavity effusion is related to tumor serous cavity metastasis. CD in serous cavity effusion may be a candidate indicator for discriminating tumor and tumor serous cavity metastasis. The combined CD and CEA determination is recommended.