Objective To investigate the value of tumor type M2 pyruvate kinase ( M2-PK) in the differential diagnosis of pleural effusion. Methods A total of 146 patients with pleural effusion during January 2006 to December 2008 were recruited at the department of respiratory medicine of the Shantou Affiliated Hospital and the First Affiliated Hospital of Sun Yat-sen Medical College. Pleural effusion was malignant in 72 cases ( 52 cases with lung cancer and 20 cases with metastatic lung cancer) and benign in 74 cases ( 54 cases with infective pleural effusion and 20 with transudation effusion) . The patients were divided into a malignant pleural effusion group, an infective pleural effusion group, and a transudation group.Then the infective group was further divided into subgroups of tuberculosis pleural effusion group and
parapneumonic effusion group. The concentration of tumor M2-PK in pleural fluid obtained during the first thoracocentesis was measured by enzyme-linked immunosorbent assay( ELISA) . Results The concentration of tumor M2-PK was significantly higher in the malignant pleural effusion group compared with the benign
pleural effusion groups ( P lt; 0. 01) . Significant differences were also found in the concentration of tumor M2-PK between malignant pleural effusion caused by lung cancer and metastatic lung cancer( P lt; 0. 05) .When the cutoff value of tumor M2-PK was set at 18. 68 U/mL, the sensitivity, specificity, and accuracy for the diagnosis of malignant pleural effusion was 87. 6% , 86. 0% , and 87. 4%, respectively. Furthermore,the detection of tumor M2-PK in combination with CEA showed better diagnostic sensitivity( 96. 0% ) ,specificity ( 85. 0% ) , and accuracy ( 91. 1% ) . Conclusions The detection of tumor M2-PK in pleural effusion is of some clinical significance in the differential diagnosis of benign and malignant pleural effusion.The detection of tumor M2-PK in combination with CEA is a good diagnostic tool with high sensitivity and
specificity.
Citation：
HUANG Bin,XIE Canmao,ZHANG Shengbin,LIN Maohuang,YU Tianfeng. Value of Tumor Type M2 Pyruvate Kinase in Differential Diagnosis of Pleural Effusion. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(3): 306-309. doi:
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Oremek GM, Teigelkamp S, Kramer W, et al. The pyruvate kinase isoenzyme tumor M2 ( Tu M2-PK) as a tumor marker for renal carcinoma. Anticancer Res, 1999, 19 : 2599 -2601.
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Hugo F, Fischer G, Eigenbrodt E. Quantitative detection of tumor M2 -PK in serum and plasma. Anticancer Res, 1999, 19: 2753-2757 .
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Riantawan P, Sanqsayan P, Banqpattanasiri K, et al. Limited additive value of pleural fluid carcinoembryonic antigen level in malignantpleural effusion. Respiration, 2000, 67 : 24-29.
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Porcel JM, Vives M, Esquerda A, et al. Use of a panel of tumor marker( carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 15-3, and cytokeratin 19 fragments) in pleural fluid for the differential diagnosisof benign and malignant effusions. Chest, 2004 ,126: 1721 -1722 .
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- 1. Seemann MD, Beinert T, Fürst H, et al. An evaluation of the tumour markers, carcinoembryonic antigen ( CEA ) , cytokeratin marker ( CYFRA 21-1 ) and neuron-specific enolase ( NSE) in the differentiation of malignant from benign solitary pulmonary lesions.Lung Cancer, 1999, 26: 149-155 .
- 2. Okuno SH, Jett JR. Small cell lung cancer: current therapy and promising new regimens. Oncologist, 2002, 7: 234-238.
- 3. 吴广平, 巴静, 王恩华, 等. 检测胸水CEA、CA125 、CA153 及CA199 对肺癌的诊断价值. 中国肺癌杂志, 2004, 7: 36-38.
- 4. 张薇, 王进, 武志芳, 等. CA125 在鉴别良恶性胸腔积液中的应用分析. 山西医药杂志, 2006, 35 : 430-431.
- 5. Eigenbrodt E, Basenau D, Holthusen S, et al. Quantification of tumor type M2 pyruvate kinase ( Tu M2-PK ) in human carcinomas.Anticancer Res, 1997, 17: 3153-3156.
- 6. Oremek GM, Teigelkamp S, Kramer W, et al. The pyruvate kinase isoenzyme tumor M2 ( Tu M2-PK) as a tumor marker for renal carcinoma. Anticancer Res, 1999, 19 : 2599 -2601.
- 7. Hugo F, Fischer G, Eigenbrodt E. Quantitative detection of tumor M2 -PK in serum and plasma. Anticancer Res, 1999, 19: 2753-2757 .
- 8. Riantawan P, Sanqsayan P, Banqpattanasiri K, et al. Limited additive value of pleural fluid carcinoembryonic antigen level in malignantpleural effusion. Respiration, 2000, 67 : 24-29.
- 9. Porcel JM, Vives M, Esquerda A, et al. Use of a panel of tumor marker( carcinoembryonic antigen, cancer antigen 125, carbohydrate antigen 15-3, and cytokeratin 19 fragments) in pleural fluid for the differential diagnosisof benign and malignant effusions. Chest, 2004 ,126: 1721 -1722 .
