血清乳酸脱氢酶的测定对视网膜母细胞瘤诊断的初步评价

Preliminary evaluation of serum lactate dehydrogenase detection in diagnosis of retinoblastoma

目的探讨视网膜母细胞瘤(retinoblastoma,RB)患者血清乳酸脱氢酶(lactatedehydrogenase,LDH)的变化及其对诊断的评价作用。方法 回顾性分析60例(84眼)RB患者及60例(60眼)对照组患者的临床资料。RB患者中,单眼患病者36例(右眼19例,左眼17例),双眼同时患病者24例;已行眼球摘除者17例(17眼)。应用Olympus2700全自动生化分析仪测定血清LDH水平。结果 RB组血清LDH平均水平为249.1U.L-1,LDH水平升高率为51.7%,对照组血清LDH平均水平为214.4U.L-1,LDH水平升高率为16.7%,2组比较差异有统计学意义(P<0.05);眼球未摘除组血清LDH平均水平为255.9U.L-1,LDH水平升高率为58.7%,眼球摘除组血清LDH平均水平226.8U.L-1,LDH水平升高率为21.4%,2组比较差异有统计学意义(P<0.05);眼球摘除组血清LDH平均水平及升高率与对照组相比差异均无统计学意义(均为P>0.05);单眼患者组血清LDH平均水平253.1U.L-1,LDH水平升高率为47.6%,双眼患者组血清LDH平均水平259.7U.L-1,LDH水平升高率为68.0%,差异均无统计学意义(P>0.05);D期以下(含D期)组血清LDH平均水平258.4U.L-1,LDH水平升高率为62.5%,E期组血清LDH平均水平251.1U.L-1,LDH水平升高率为53.8%,2组比较差异无统计学意义(P>0.05)。结论 血清LDH水平测定可作为RB辅助性诊断标准之一,同时也可以作为判断眼球摘除术后是否有肿瘤残留或复发的评价指标之一。

Objective To discuss the changes of serum lactate dehydrogenase（LDH） in retinoblastoma（RB） and its preliminary evaluation in the diagnosis of RB.Methods Sixty patients with RB and 60 cases as control were retrospectively analyzed.The RB patients included 36 monocular cases（19 cases in right,17 cases in left） and 24 binocular cases.The enucleation of eyeball was performed in 17 cases（17 eyes）.Serum LDH was detected by Olympus 2700 automatic biochemical analyzer.Results The mean level of serum LDH in the RB group,the control,patients with enucleation,patients without enucleation,monocular patients,binocular patients,patients below D stage and patients with E stage were 249.1 U·L-1,214.4 U·L-1,226.8 U·L-1,255.9 U·L-1,253.1 U·L-1,259.7 U·L-1,258.4 U·L-1 and 251.1 U·L-1,respectively,the increased rate of LDH were 51.7%,16.7%,21.4%,58.7%,47.6%,68.0%,62.5% and 53.8%,respectively.Level of serum LDH between the RB group and the control,patients with or without enucleation were statistically different（All P0.05）.The level between patients with enucleation and the control group,monocular and binocular patients,patients below D stage and patients with E stage were not significantly different（All P0.05）.Conclusion The detection of serum LDH can be one of the assistant diagnosis of RB and help to evaluate whether or not there is residue or relapse of RB after enucleation.