LD、β2-M、CA125在非霍奇金淋巴瘤中的临床意义

Clinical significance of combined detection of the serum levels of LDH,β2- M and CA-125 in the diagnosis of NHL

目的:研究血清肿瘤标志物乳酸脱氢酶(lactic dehydrogenate,LDH)、β2微球蛋白(β2-microglobulin,β2-M)和糖链核心蛋白抗原(carbohydrate,CA-125)与非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)组织学分型、分期和疗效的关系,并探讨联合检测的意义。方法:分别采用速率法、免疫比浊法和电化学发光法测定48例NHL患者、22例健康者和8名淋巴结良性病者血清LDH、β2-M、CA125水平。结果:(1)NHL组血清肿瘤标志物LDH、β2-M、CA125水平明显升高,与淋巴结良性病组和健康体检组比较差异有统计学意义(P<0.05),淋巴结良性病组和健康体检组比较,三种肿瘤标记物水平差异无统计学意义(P>0.05);(2)血清LDH、β2-M、CA125水平在NHL中的高度恶性组、中度恶性组、低度恶性组之间差异无统计学意义(P>0.05);(3)NHL组中Ⅲ～Ⅳ期的LDH、β2-M、CA125水平高于Ⅰ～Ⅱ期,差异有统计学意义(P<0.05);(4)LDH、β2-M、CA125水平在化疗后缓解组明显减低,差异有统计学意义(P<0.05),未缓解组治疗前后三种肿瘤标志物水平则无显著变化(P>0.05);(5)联合检测三种肿瘤标记物的阳性率高于单项检测,可提高NHL临床诊断价值。结论:(1)NHL患者LDH、β2-M、CA125水平增高,但与恶性程度无关。(2)NHL组中Ⅲ～Ⅳ期的血清LDH、β2-M、CA125水平较Ⅰ～Ⅱ期升高;(3)化疗前后三种肿瘤标志物血清水平变化部分反映疗效,监测肿瘤标志物有助于临床疗效判断;(4)联合检测LDH、β2-M、CA125可提高对NHL诊断阳性率。

Objective： To study the adjuvant diagnosis value of the three serum tumor markers, lactic dehydrogenase （LDH）, beta2 microglobulin （β2-M） and CA-125 in non-Hodgkin＇s lymphoma. Methods： The serum levels of LDH, β2-M and CA-125 were examined by velocity method, immunoturbidimetry and electrochemiluminescence, including 48 patients, 22 healthy persons and 8 lymphatic neagative patients. Results： （1） The serum levels of LDH, β2-M and CA-125 in non-Hodgkin patients were higher than other groups; （2） There was no statistical significance in examining the serum levels of LDH, β2-M and CA-125 in non-Hodgkin＇s patients in high malignancy group, middle malignancy group and low malignancy group （P 〉0.05）; （3） The serum levels of LDH, β2-M and CA-125 in phase Ⅲ and Ⅳ were higher than phase Ⅰ and Ⅱ （P 〈0.05）; （4） The serum levels of LDH, β2-M and CA-125 in remission group after chemotherapy were decreased with stastical significance （P 〈0. 05）. In non-remission group, there was no difference; （5） The combined assay of three serum tumor markers could enhance diagnostic value of NHL. Conculsion： （1） There was no diffience between different histological classification of the serum level of each tumor maker. （2） The serum levels of LDH, β2-M and CA-125 in phase Ⅲ and Ⅳ are higher than phase Ⅰ and Ⅱ ; （3） The change in the three serum tumor markers before and after the chemotherapy has partly reflected the effect and improved the diagnostic value of NHL; （4） The three tumor markers have different adjuvant diagnosis value to NHL and the combined detection of them can enhance their clinical diagnosis value.