肿瘤型M2-丙酮酸激酶在乳腺癌诊断与疗效监测中的价值

摘要

Objective To evaluate application value of plasma tumor type M2 pyruvate kinase (TU M2-PK) in the treatment effect monitoring in breast cancer. Methods TU M2-PK was determined by ELISA in breast cancer patients (n = 63 ), benign breast disease patients (n = 22 ) and health controls (n = 40).The receiver operation characteristic (ROC) analysis was performed as compared with CA15-3 and CEA. Results ROC analysis showed the cut-off was set at 14. 1 U/ml for TU M2-PK ( sensitivity 46. 0% ;specificity 86. 0% ), and the diagnosis efficacy of TU M2-PK was higher than CA15-3 and CEA. The level of TU M2-PK was significantly higher in breast cancer patients (13. 3 U/ml) than that in health controls (7. 2 U/ml, U = 408. 5, P < 0. 05 ) and in benign breast disease patients ( 11.1 U/ml, U = 509.0,P < 0. 05 ). With the progression of breast carcinoma, the level of TU M2-PK as well as the positivity was increased. TU M2-PK concentration was higher in patients with lymph node metastasis (23. 3 U/ml ) than those without metastasis ( 10. 9 U/ml, U = 237. 0, P < 0. 01 ). The level of TU M2-PK correlated with therapy response. An elevated level of TU M2-PK was found preclinically in recurrent disease patients, and the levels decreased in the patients, which showed sensitive to chemotherapy. The TU M2-PK level was kept at baseline in patients with stable disease. Conclusion TU M2-PK is helpful in the diagnosis of breast cancer, and it is a valuable tumor marker for disease monitoring, therapy control and prognosis evaluation in breast cancer.%目的 评估肿瘤型M2-丙酮酸激酶(Tu M2-PK)在乳腺癌诊断与疗效监测中的应用价值.方法 用ELISA检测63例乳腺癌患者、22例乳腺良性疾病患者及40名健康对照者血浆Tu M2-PK水平,并与糖类抗原15-3(CA15-3)、癌胚抗原(CEA)测定结果对比分析.结果 根据受试者工作特征(ROC)曲线分析,Tu M2-PK检测乳腺癌的临界值为14.1 U/ml,敏感度为46.0%,特异度为86.0%,提示其诊断价值高于CA15-3(敏感度为42.8%,特异度为85.4%)和CEA(敏感度为36.5%,特异度为90.0%).乳腺癌患者血浆中TU M2-PK水平(13.3 U/ml)明显高于健康对照(7.2 U/ml,U=408.5,P<0.05)以及乳腺良性疾病患者(11.1 U/ml,U=509.0,P<0.05).乳腺癌患者血浆TUM2-PK水平及敏感度随着肿瘤分期、分级的升高而升高;淋巴结转移患者TU M2-PK水平(23.3 U/ml)显著高于未转移者(10.9 U/ml,U=237.0,P<0.01).TU M2-PK水平与疗效密切相关,病情恶化或出现转移时TU M2-PK升高,在临床治疗有效时又有所下降;而患者病情稳定时,基本维持在同一水平.结论 TU M2-PK测定可提高对乳腺癌诊断的敏感度,是乳腺癌患者病情监测、疗效观察及预后判断的有效指标.