联合检测肿瘤M2型丙酮酸激酶、CEA对并发胸腔积液的肺癌的诊断价值

摘要

Objection To analyze the clinical variables of Tumor M2-PK and CEA in lung cancer with pleural effusion. Methods We detected the levels of the M2-PK with ELISA and CEA with chemiluminescent immunoassay in 44 cases with benign pleural effusion and 35 cases with malignant pleural effusion. We compared the differences between them. Result The concentrations of M2-PK and CEA in the malignant pleural effusion were, respectively, (28.45 ± 8. 63 ) U/ml, ( 19. 55 ± 12. 93 ) ng/ml, The concentrations of M2-PK and CEA in the benign pleural effusion were, respectively, (19. 48 ± 6. 75) U/ml, (7. 79 ± 4. 47 ) ng/ml. The concentrations of M2-PK and CEA in the malignant pleural effusion were significanfiy higher than the benign pleural ffusion ( P ＜0. 05 ). The diagnostic criteria for≥30 U/ml of M2-pk, were as follows: The Sensitivity was 42. 86％, specificity was 90. 91％, positive predictive value(PPV) was 78. 95％,and the negative predictive value (NPV) was 66. 67％. The diagnostic criteria for ≥ 10ng/Ml of CEA, were as follows: The sensitivity was 65.71％, specificity was 72. 73％, positive predictive value (PPV) was 65.71％, and the negative predictive value (NPV) was 72. 73％. Combined the M2-PK with the CEA showed the following, The sensitivity was 82. 86％, specificity was 63.64％, positive predictive value (PPV) was 64. 44％, and the negative predictive value ( NPV ) was 82. 35 ％. The Detection of the M2-PK and CEA in the pleural effusion together could improve the level of the diagnosis of lung cancer with pleural effusion. Conclusion The level of Tumor M2-PK and CEA in malignant pleural effusion is significantly higher than in benign pleural effusion. Combined measurement of M2-PK with the CEA could improve the a level for the diagnosis of benign and malignant pleural effusion.%目的 检测胸腔积液中肿瘤M2型丙酮酸激酶(Tumor M2-Pyruvate kinase,Tu M2-PK)和癌胚抗原(carcinoembbryonic antigen,CEA),探讨M2-PK和CEA在并发胸腔积液的肺癌患者的临床诊断价值.方法 利用夹心ELISA 法测定44例良性胸液和35例并发胸腔积液的肺癌患者的M2-PK,CEA值.比较两组之间的差异.结果 肺癌并胸腔积液组M2-PK、CEA值分别为(28.45±8.63) U/ml,(19.55±12.93) ng/ml;良性胸液组M2-PK、CEA值分别为(19.48±6.75) U/mL,(7.79±4.47) ng/ml,恶性胸液组中M2-PK和CEA值均明显高于良性胸液组(P<0.05).联合检测的灵敏度为82.86%,特异度为63.64%,阳性预测值为64.44%及阴性预测值为82.35%.联合检测胸腔积液中的M2-PK和CEA能够显著提高并发胸腔积液患者的肺癌诊断水平.结论 M2-PK和CEA在恶性胸液组中明显升高,联合检测胸液中M2-PK和CEA可提高对并发胸腔积液的肺癌患者的诊断水平.