Diagnostic Values And Clinical Significance Of Detecting Adrenomedullin In Differentiating Lung Cancer From Pulmonary Tuberculosis Or Differentiating Malignant Pleural Effusion From Tuberculous Pleural Effusion, Comparing With Carcinoembryonic Antige

Objective To explore the diagnostic values and clinical significance of adrenomedullin in differentiating lung cancer from pulmonary tuberculosis and differentiating malignant pleural effusion from tuberculosis pleural effusion, to provide the experimental basis of diagnosis and treatment of them.Method The concentration of AM and carcinoembryonic antigen (CEA) in the blood are separately measured in patients afflicted with lung cancer, pulmonary tuberculosis and normal control group by radioimmunoassay(RIA) , the concentration of AM in malignant pleural effusion and tuberculosis pleural effusion are measured by the same method .Results (1) The level of AM (98. 46 ±29. 28 pg/ml)in the plasma of patients afflicted with lung cancer is the highest in the patients afflicted with lung cancer , pulmonary tuberculosis (61. 46 ± 19. 57 pg/ml)and normal controls (40. 22 ± 8. 23 pg/ml), there is markedly statistical significance among them(P<0. 01). The level of CEA(33. 13 ± 26. 72ng/ml) in the serum of patients afflicted with lung cancer is the highest in patients afflicted with lung cancer .pulmonary tuberculosis(10. 62 ± 3. 26 ng/ml)and normal controls (9. 88 ± 3. 31ng/ml), there is markedly statistical significance among them. A positive correlation exists between the level of AM in the plasma of patients afflicted with lung cancer and the stage of this disease (P<0. 05). The level of AM in the plasma of patients afflicted with small cell carcinoma is lower than that in the plasma of patients afflicted with lung adeno-carcinoma and squamous cell carcinoma (P<0. 05). (2)The level of AM and CEA in the malignant pleural effusion(115. 05 ±31. 06pg/ml,34. 75 ± 25. 17ng/ml)are significantly higher than those in the tuberculosis pleural effusion(71. 40±10. 80 pg/ml,9. 55±3. 47 ng/ml), there is markedly statistical significance between them(P-<0. 01). (3)The level of AM and CEA in the malignant pleural effusion (131. 96±28. 00pg/ml,4 7. 66±23. 04ng/rnDare higher than those(113. 83±16. 96pg/ml,37. 97 ± 29. 22ng/ml)in the blood, there is markedly statistical significance between them(P<0. 01). (4)The sensitivity of AM and CEA in the blood for making diagnosis of lung cancer are 65. 1%(28/43) and 41. 9%(19/ 43) respectively if 90. 19 pg/ml and 15.00ng/ml are regarded as the limit respectively ,the sensitivity of AM is higher than that of CEA, the sensitivity is 81. 4%(35/43)when combination is applied, and there is statistical significance between them(P<0. 05). The sensitivity of AM and CEA in the pleural effusion for making diagnosis of malignant pleural effusion are 75. 0% (27/36) and 52. 8% (19/36) respectively , the accuracy (the rate of right dianostic)of AM and CEA are 86. 1% (62/72) and 77. 8% (56/72) respectively if 90. 51 pg/ml and 15. 00ng/ml are regarded as the limit respectively ,the sensitivity and accuracy of AM are higher than that of CEA, the sensitivity and accuracy are 86. l%(31/36) and 66/72(90. 3%)when combination is applied, and there is statistical significance between them(P<0. 05).Conclusions (1)AM can be regarded as a mark of differentiating lung cancer from pulmonary tuberculosis and differentiating malignant pleural effusion from tuberculosis pleural effusion.(2)The level of AM in the plasma can reflect the condition and the prognosis of the patient afflicted with lung cancer. (3)AM is closely correlated with lung cancer, disrupting the binding of AM and its receptor or signal transduction pathways could be a new way to cure lung cancer.