唾液中ALP、LDH水平在口咽癌早期诊断中的潜在应用价值  

Potential value of salivary ALP and LDH in early diagnosis of oropharyngeal carcinoma

作　　者：夏章晖[1] 付小红[2] XIA Zhanghui;FU Xiaohong(Department of Stomatology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430077,Hubei Province;Department of Stomatology,Wuhan First Hospital,Wuhan 430030,Hubei Province,China)

机构地区：[1]华中科技大学同济医学院附属梨园医院口腔科,湖北武汉430077 [2]武汉市第一医院口腔科,湖北武汉430030

出　　处：《口腔颌面外科杂志》2023年第4期237-242,共6页Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨唾液碱性磷酸酶(alkaline phosphatase,ALP)、乳酸脱氢酶(lactate dehydrogenase,LDH)在口咽癌早期诊断中的应用价值。方法:选取2018年1月—2022年1月我院收治的77例口咽癌患者(口咽癌组)、61例良性口腔肿瘤患者(良性组)和51例体检健康的志愿者(对照组),检测患者唾液中ALP、LDH水平,收集临床资料和病理相关信息。分析唾液中ALP、LDH水平与口咽癌发病、临床病理特征的关系,以及诊断口咽癌的价值。结果:口咽癌组唾液ALP、LDH水平高于良性组和对照组(P<0.001);低中分化、TNMⅡ期、颈部淋巴结转移患者唾液ALP、LDH水平高于高分化、TNMⅠ期和无颈部淋巴结转移患者(P<0.001)。吸烟、高危人乳头状瘤病毒(human papilloma virus,HPV)感染、口腔溃疡、唾液高水平ALP和LDH是口咽癌发病的危险因素(P<0.01)。唾液ALP、LDH诊断口咽癌曲线下面积为0.918,大于单独诊断的0.649、0.769(z=5.626、3.787,P<0.05)。结论:口咽癌患者唾液中ALP和LDH水平明显增高,且与口咽癌发生和恶性病理特征有关,联合ALP和LDH诊断口咽癌具有较高效能,可作为口咽癌早期诊断的标志物。Objective:To investigate the potential application value of salivary alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)in early diagnosis of oropharyngeal carcinoma.Methods:A total of 77 patients with oropharyngeal cancer(cancer group),61 patients with benign oral tumors(benign group)and 51 healthy volunteers(control group)from January 2018 to January 2022 were selected.The levels of ALP and LDH in saliva were detected between each group,and the clinical data and pathological information were collected.The relationship between salivary ALP,LDH level and the incidence rate of oropharyngeal carcinoma,clinicopathological features of oropharyngeal carcinoma were statistically compared.Results:The expression levels of salivary ALP and LDH in oropharyngeal carcinoma group were higher than those of benign group and control group(P<0.001).The levels of salivary ALP and LDH in patients with low or moderate differentiation,TNM stageⅡand cervical lymph node metastasis were higher than those of patients with high differentiation,TNM stageⅠand no cervical lymph node metastasis cases(P<0.001).Smoking,high-risk human papilloma virus infection,oral ulcer,high levels of salivary ALP and LDH were risk factors for the incidence of oropharyngeal cancer(P<0.01).The area under the curve of salivary ALP and LDH in the diagnosis of oropharyngeal carcinoma was 0.918,which were greater than the individual diagnosis result of 0.649,0.769(z=5.626、3.787,P<0.05).Conclusion:The levels of salivary ALP and LDH in patients with oropharyngeal carcinoma are significantly increased,which are related to the occurrence of oropharyngeal carcinoma and tumor behavior.Salivary ALP and LDH level can be used as a marker for early diagnosis of oropharyngeal carcinoma.

关 键 词：碱性磷酸盐 乳酸脱氢酶 口咽癌 危险因素 诊断 

分 类 号：R782[医药卫生—口腔医学] R739.8[医药卫生—临床医学]