联合检测肿瘤M2型丙酮酸激酶、CEA对并发胸腔积液的肺癌的诊断价值

Application of detecting tumor M2-PK and CEA in pleural effusion for clinical diagnosis of malignant pleural effusion caused by lung cancer

目的检测胸腔积液中肿瘤M2型丙酮酸激酶(TumorM2-Pyruvate kinase,Tu M2-PK)和癌胚抗原(carcinoembbry-onicantigen,CEA),探讨M2-PK和CEA在并发胸腔积液的肺癌患者的临床诊断价值。方法利用夹心ELISA法测定44例良性胸液和35例并发胸腔积液的肺癌患者的M2-PK,CEA值。比较两组之间的差异。结果肺癌并胸腔积液组M2-PK、CEA值分别为(28.45±8.63)U/m l,(19.55±12.93)ng/ml;良性胸液组M2-PK、CEA值分别为(19.48±6.75)U/mL,(7.79±4.47)ng/m l,恶性胸液组中M2-PK和CEA值均明显高于良性胸液组(P<0.05)。联合检测的灵敏度为82.86%,特异度为63.64%,阳性预测值为64.44%及阴性预测值为82.35%。联合检测胸腔积液中的M2-PK和CEA能够显著提高并发胸腔积液患者的肺癌诊断水平。结论 M2-PK和CEA在恶性胸液组中明显升高,联合检测胸液中M2-PK和CEA可提高对并发胸腔积液的肺癌患者的诊断水平。

Objection To analyze the clinical variables of Tumor M2-PK and CEA in lung cancer with pleural effusion.Methods We detected the levels of the M2-PK with ELISA and CEA with chemiluminescent immunoassay in 44 cases with benign pleural effusion and 35 cases with malignant pleural effusion.We compared the differences between them.Result The concentrations of M2-PK and CEA in the malignant pleural effusion were,respectively,（28.45±8.63） U/ml,（19.55±12.93） ng/ml,The concentrations of M2-PK and CEA in the benign pleural effusion were,respectively,（19.48±6.75） U/ml,（7.79±4.47） ng/ml.The concentrations of M2-PK and CEA in the malignant pleural effusion were significantly higher than the benign pleural ffusion（P0.05）.The diagnostic criteria for≥30 U/ml of M2-pk,were as follows： The Sensitivity was 42.86%,specificity was 90.91%,positive predictive value（PPV） was 78.95%,and the negative predictive value（NPV） was 66.67%.The diagnostic criteria for ≥10ng/Ml of CEA,were as follows： The sensitivity was 65.71%,specificity was 72.73%,positive predictive value（PPV） was 65.71%,and the negative predictive value（NPV） was 72.73%.Combined the M2-PK with the CEA showed the following,The sensitivity was 82.86%,specificity was 63.64%,positive predictive value（PPV） was 64.44%,and the negative predictive value（NPV） was 82.35%.The Detection of the M2-PK and CEA in the pleural effusion together could improve the level of the diagnosis of lung cancer with pleural effusion.Conclusion The level of Tumor M2-PK and CEA in malignant pleural effusion is significantly higher than in benign pleural effusion.Combined measurement of M2-PK with the CEA could improve the a level for the diagnosis of benign and malignant pleural effusion.