胃肠道恶性肿瘤患者血浆肿瘤型M2-丙酮酸激酶的测定及其临床价值

Clinical value of plasma tumor type M2 pyruvate kinase determination in patients with gastrointestinal cancer

目的评估肿瘤型M2丙酮酸激酶(TU M2-PK)作为一种肿瘤标志物在胃肠道恶性肿瘤患者临床诊疗中的应用价值。方法用酶联免疫吸附试验(ELISA)检测106例胃肠道恶性肿瘤患者、20例胃肠道良性疾病患者以及40名健康体检者的血浆TU M2-PK,并结合癌胚抗原(CEA)、糖类抗原72-4(CA72-4)、糖类抗原50(CA50)等指标进行比较分析。结果胃肠道恶性肿瘤患者血浆中TU M2-PK水平显著高于胃肠道良性疾病组和健康对照组(P<0.01),其总体敏感性为67.0%,总体特异性为78.3%。随着肿瘤病程进展,中、晚期患者血浆中TU M2-PK水平明显高于早期患者(P<0.01);淋巴结转移患者TU M2-PK水平显著高于未转移者(P<0.05)。此外,联合CEA、CA72-4及CA50测定时,胃肠道恶性肿瘤诊断敏感度可有所提高。结论TUM2-PK测定可提高对胃肠道肿瘤诊断的有效性,也是胃肠道肿瘤患者病情监测及预后评估的有效指标。

Objective To evaluate the plasma tumor M2 pyruvate kinase （TU M2-PK） as a biomarker in gastrointestinal cancer. Methods The levels of TU M2-PK in 106 patients with gastrointestinal cancer, 20 patients with benign gastrointestinal disease and 40 healthy controls was determined by enzyme-linked immunosorbent assay, and the results were compared with those of the carcinoembryonic antigen （ CEA）, carbohydrate antigen 72-4 （ CA72-4 ） and carbohydrate antigen 50 （ CAS0）. Results The levels of TU M2-PK in patients with gastrointestinal cancer was significantly higher than that in controls （P 〈0.01 ）. The cutoff value was established at 15 U/mL for TU M2-PK, the sensitivity and specificity were 67.0% and 78.3% , respectively. With the progression of carcinoma, the level of TU M2-PK was increased significantly. The level of TU M2-PK in patient with lymph node metastasis was higher than those in patient without metastasis （P 〈0.05 ）. Combined determination of TU M2-PK with CEA, CA72-4 and CAS0 increased the diagnostic sensitivity of gastrointestinal cancer. Conclusions TU M2-PK is a valuable tumor marker of gastrointestinal cancer for the diagnosis, monitoring and prognosis of the desease.