【摘要】 目的探讨血浆肿瘤型M2丙酮酸激酶(TuM2-PK)水平在直肠癌患者中的变化,以及在直肠癌诊断与病情监测方面的价值。方法采用ELISA定量检测153例直肠癌患者、50例直肠良性肿瘤患者及32例健康对照者血浆TuM2-PK水平,比较3组间TuM2-PK的表达差异。以TuM2-PK>15U/mL判断为阳性结果,分析不同临床病理参数直肠癌患者的TuM2-PK阳性率差异。ROC曲线法分析TuM2-PK诊断直肠癌TNM分期Ⅰ期、Ⅱ期的性能,Spearman分析血浆TuM2-PK与直肠癌各临床病理参数的相关性。结果直肠癌组、直肠良性病变组及健康对照组血浆TuM2-PK水平中位数分别为23.00、14.57、12.68U/mL,直肠癌组明显高于良性病变组及健康对照组(P<0.05),良性病变组与健康对照组血浆TuM2-PK水平差异无统计学意义(P>0.05)。直肠癌不同分化程度、TNM分期、是否存在淋巴结转移时的TuM2-PK表达阳性率存在明显差异;TuM2-PK诊断直肠癌及TNM分期Ⅰ期、Ⅱ期的曲线下面积分别为0.72、0.74、0.77;TuM2-PK水平与肿瘤细胞分化程度、淋巴结转移与否、TNM分期有关;血浆TuM2-PK检测直肠癌的灵敏度为62%,特异度为58%。结论血浆TuM2-PK变化与病情有一定相关性,对直肠癌的TNM分期、浸润转移的判断有帮助,可辅助诊断直肠癌。更多还原

【Abstract】 Objective To evaluate the value of plasma tumor M2 pyruvate kinase(TuM2-PK)in diagnosis and monitoring of rectal cancer.Methods The plasma TuM2-PK was determined by ELISA and compared in rectal cancer patients(n=153),patients with benign rectal disease(n=50)and healthy controls(n=32).TuM2-PK>15U/mL as the positive standard,the positive rate of TuM2-PK in patients with different pathological parameters were compared.Receiver Operating Characteristic Curve(ROC)was used to analyze performance of TuM2-PK in diagnosis for TNMⅠ and Ⅱ of rectal cancer,Spearman method was used to analyze the correlation between TuM2-PK and different pathological parameters.Results The median of the plasma TuM2-PK levels in cancer group,rectal benign group and healthy control group were 23.00,14.57,12.68U/mL,the level in the cancer group was significantly higher than those in the other two groups(P<0.05),but there was no significant difference between benign disease group and healthy control group(P>0.05).The plasma TuM2-PK and tumor cell differentiation,lymph node metastasis,TNM stage was related in rectal cancer patients.The sensitivity and specificity of TuM2-PK in plasma on diagnosis for rectal disease was 62% and58%.The AUC of diagnosis rectal cancer and TNMⅠ phase cancer,TNMⅡ phase cancer were 0.72,0.74,0.77 respectively.Conclusion The plasma TuM2-PK has high clinical value for the diagnosis and monitoring of rectal cancer,and has a certain significance in determined cancer clinical stage,invasion and metastasis.更多还原