AM检测对肺癌与肺结核鉴别诊断价值的研究

Study on the Diagnostic Value of Plasma Adrenomedullin (AM) Levels Determination for Differentiation of Pulmonary Cancer From Pulmonary Tuberculosis

目的:研究肾上腺髓质素(adrenomedullin,AM)对肺癌与肺结核鉴别诊断的意义,为肺癌与肺结核 的诊治提供实验依据。方法:应用放射免疫分析(RIA)分别检测肺癌、肺结核组病人及正常对照组外周血中 AM含量。结果:肺癌组病人血浆中AM含量(98.46±29.28)ng/ml明显高于肺结核组(61.46±19.57)ng/ml 及正常对照组(40.22±8.23)ng/ml,有极显著差别(P<0.01)。小细胞肺癌组病人AM含量较鳞癌、腺癌组病 人AM含量低,有显著性差异(P<0.05)。鳞癌、腺癌组病人AM含量无明显差异(P>0.05)。随着肺癌病情 的进展,从肺癌Ⅰ期至Ⅳ期AM逐渐升高,有显著性差异(P<0.05)。结论:AM的检测可作为肺癌诊断及与肺 结核鉴别诊断的实验室指标。AM的含量对肺癌的分期和预后的评价有重要价值,尤其对缺少病理资料的肺 癌患者有初步诊断的意义。

Objective To explore the relationship between plasma adrenomedullin (AM) levels and pulmonary cancer as well as the diagnostic value of AM levels determination for differentiation of pulmonary cancer from pulmonary tuberculosis. Methods Plasma levels of AM in patients with palmonary cancer (n=43), pulmonary tuberculosis (n=43) and 43 controls were determined with RIA. Results Plasma levels of AM (98.46±29.28ng/ml) in patients with pulmonary cnacer were significantly higher than those in patients with pulmonary tuberculosis (61.46±19.57ng/ml) as well as those in controls (40.22±8.23ng/ml) (both P<0.01). Levels in patients with small cell carcinoma were significantly lower than those in patients with adenocarcinoma and squamous cell carcinoma (both P<0.05). Positive correlation existed between the plasma levels of AM and the severity (grading 1 to 4) of the disease (P<0.05). Conclusion Adrenomedullin could be regarded as a valuable plasma marker for differentiating lung cancer from tuberculosis. The plasma AM levels might be able to reflect the severity and predict the prognosis of the disease. Besides, high AM levels might suggest a tentative diagnosis of lung cancer in patients without pathologic evidence.