血清前清蛋白测定在肿瘤良恶性鉴别诊断中的价值  

Diagnostic value to measure serum prealbumin in distinguishing benign from malignant tumors

作　　者：文国泰[1] 刘成桂[1] 邓成莲[1] 马艳[1] 

机构地区：[1]四川省医学科学院附属医院病理科,四川简阳641400

出　　处：《四川医学》2008年第4期416-418,共3页Sichuan Medical Journal

摘　　要：目的探索血清前清蛋白（PA）、清蛋白（ALB）和总蛋白（TP）在评价肿瘤患者营养状况中的意义，探讨PA对良、恶性肿瘤的鉴别诊断价值。方法对84例恶性肿瘤（肝癌17例，胃、肠癌27例，白血病8例，肺癌8例，宫颈、卵巢癌7例，其他恶性肿瘤17例）、67例良性肿瘤（畸胎瘤10例，葡萄胎8例，子宫平滑肌瘤18例，脂肪瘤11例，卵巢囊肿11例，其他良性肿瘤9例）及50例健康对照者，分别用透射免疫比浊法测定PA、溴甲酚绿法测定ALB，双缩脲法测定TP。结果恶性肿瘤患者血清PA（204．8±67．2）mg/L，明显比良性肿瘤患者血清PA（305．1±28．6）mg／L和健康对照组PA（303.5±29．7）mg／L低（F=101．78，P〈0．01），而3组ALB和TP比较差异无统计学意义（F=2．54～2，62，P〉0．05）；PA、ALB和TP对恶性肿瘤患者营养不良检出率分别为76．19％、19．05％和2．38％，3指标比较差异有统计学意义（X^2=111．45，P〈0．01）；恶性肿瘤患者中，以肝癌营养不良发生率最高，达94．12％，胃、肠癌其次，为77．78％，白血病再次，为75．00％。结论血清PA能更好地反映机体的营养状况，对良、恶性肿瘤的鉴别诊断有一定价值。Objective To explore the significance to measure serum prealbumin（PA） ,albumin（ALB） and total protein（TP） in the assessment of malnutrition in patients with tumor and to study the diagnostic value in distinguishing benign from malignant tumors using PA.Methods PA,ALB and TP were measured in 84 malignant tumor patients（ 17 carcinoma of live,27 stomachal and colorectal cancer, 8 leukemia, 8 carcinoma of lung,7 cervical and ovarian cancer, 17 other malignant tumors}and in 67 benign tumor patients（ 10 teratoma,8 hydatidiform mole, 18 fibromyoma uteri, 11 liparomphalus, 11 ovarian cyst and 9 other benign tumors ） and in 50 healthy subjects by the transmission immunoturbidimetry,bromcresol green （BCG） and Doumas methods,respectively. Results The study revealed that patients with malignant tumor had obviously lower levels of PA compared to that with benign tumor and controls（ analysis of variance [ANOVA], F = 101.78, P 〈 0.01 ） ,the levels of PA were（204.8 ± 67.2） mg/L for malignant tumor group, （305.1 ± 28.6） mg/L for benign tumor group and （303.5 ± 29.7 ）mg/L for controls, respectively. Not only the concentration of ALB but also the level of TP, however, there were no significant difference in these three groups. In malignant cancer group, malnutrition detection ratio were 76.19%, 19.05 % and 2.38% by PA, ALB and TP, respectively and there was markedly difference among these three parameters（ X^2 = 111.445, P 〈 0.01 ）. The incidence of malnutrition of hepatoma was the highest （94.12%）, and stomachal and colorectal cancer was secondly higher（77.78% ）and leukemia was thirdly higher（75.00% ）. Conclusion The serum PA is better in reflection of nutritional status and has certainly value to identify diagnosis between benign and malignant tumors.

关 键 词：前清蛋白 营养不良 良性肿瘤 恶性肿瘤 

分 类 号：R730.4[医药卫生—肿瘤]