头颈部恶性肿瘤患者β-葡萄糖苷酸酶活性的检测

A study on activity of beta-glucuronidase in serum and secretion from upper respiratory tract in patients with head and neck malignant tumors

研究头颈部恶性肿瘤患者上呼吸道分泌物和血清中β－葡萄糖着酸酶（beta－glu－curonidase，β－GD）活性变化。采用微量比色法检测头颈部恶性肿瘤患者、健康人和头颈部良性疾患者各40例上呼吸道分泌物和血清中β－GD活性，并进行对比研究。结果表明：三级血清中β－GD活性差异无显著性；上呼吸道分泌物中β－GD活性在健康人群组与良性疾患组间差异亦无显著性，而恶性肿瘤组则明显升高，与前两级相比，差异有极显著性（P＜0．001），若以正常对照组的均数加两个标准差为阳性判断标准，则敏感性、可靠性和特异性分别为85．0％、92．5％和100％。晚期、有淋巴结或远处转移者β－GD活性较早期、未发生转移者升高更明显。对6例恶性肿瘤患者治疗前后上呼吸道分泌物中β－GD活性进行一年的动态监测，其变化气临床症状相一致。实验结果提示上呼吸道分泌物中β－GD活性的检测可作为头颈部恶性肿瘤早期诊断、临床分期分级、疗效评估及判断肿瘤有无复发或转移的有价值的辅助指标。

Beta-glucuronidase (β-GD) activity in serum and upper respiratory tract (URT) se-cretion in patients with head and neck malignant tumors (HNMT) was studied. Subjects included 40HNMT patients, 40 healthy volunteers and 4o patients with benign tumors of the head and neck re-gion. The results showed that there was no statistically significant difference of serum β-GD level a-mong the three groups. The same was true for URT secretion between the normal cpntrol and benigntumor groups. β-GD level in URT secretion was higher in HNMT group than in other groups (P<0.001). Using healthy subjects' average β-GD level plus two standard difference as positive stan-dard, the sensitivity, reliability and specificity of the test were 85. 0%, 92- 5% and 1OO% respective-ly. β-GD levels were higher in patients with advanced tumors and metastases. One year follow-ups of six patients showed that β-GD level change in URT secretion was in accordance with clinical manifes-tati ons. These results suggest that assay of 9-GD level in URT secretion can be used as a valuable supplimental parameter in early diagnosis of HNMTs, their clinical staging, evaluation of therapeutic effectiveness and detection of recurrence and metastases. In addition, this method has the advantage of easy, prompt, result specificity, sensitivity and reliability.