A Study About Expression Level Of A-Enolase Between Benign Pleural Effusion And Malignant Pleural Effusions And Its Clinical Value

Objective:To study the differential value of of α-enolase between benign pleural effusion and malignant pleural effusions by detecting their expression in the pleural effusions. The aim of this research is to find new method for clinical diagnosis of cancerous pleural effusion.Method:Selecting the60patients with pleural effusions in pneumoiogy department the First Affiliated Hospital of Kunming Medical University in May2013to January2014. All cases were divided into two groups:30cases of malignant pleural effusion and30cases of benign pleural effusion (tuberculous pleurisy in20cases; cardiac insufficiency and/or hepatic insufficiency in5cases; parapneumonia pleural effusion5cases); Malignant pleural effusion group was divided into2groups according to the pathological type of lung cancer (lung adenocarcinoma in19cases and lung squamous carcinoma in11cases). Respectively, to detect the concentration of alpha enolase in pleural effusion by using Enzyme-linked immunosorbent(ELISA) experiment, and to establish a reasonable clinical judgment value according to the subjects work curve (ROC).Result:1. The basic clinical data of patients, LDH in pleural effusion,malignant group is higher than benign (P＜0.05), the difference is statistically significan：ADA in benign group is higher than malignant(P<0.05);the difference is statistically significant. Serum CEA、 CA12-5and CA19-9,malignant group is higher than benign (P<0.05), the difference is statistically significan： But age, sex,serum total protein, pleural effusion TP between the two groups, the difference is not statistically significant (P>0.05).2. ELISA detected the concentrations of alpha enolase (ng/ml):(1) Compared with benign pleural effusion group, there was a significantly increased in malignant pleural effusion group (150.04±47.87,96.33±45.13, P＝0.000<0.001), the difference was statistically significant;(2) The protein expression of alpha enolase in malignant pleural effusion group associated with tumor pathological type, there was a signify-cantly increase in concentration of lung adenocarcinoma group, compared with the squamous carcinoma group (165.26±41.81,123.84±48.01, P=0.000<0.001), the difference was statistically significant.(3) According to an Youden index about123.35pg/ml as best cutoff value of alpha enolase for malignant pleural effusion of sensitivity and specificity were70%and73%.Conclusion:1. There is certain value that the measurement of CEA. CA12-5and CA19-9concentration in serum to identify benign and malignant pleural effusion.2. Using ELISA detection, the protein expression concentration of alpha enolase was higher in malignant pleural effusion than in benign pleural effusion, and has certain sensitivity, specificity in judging malignant pleural effusion,can be used as a new detection index in the auxiliary diagnosis of lung cancer.3. According to the ELISA results, there was a significantly increase in concentration of lung adenocarcinoma group, compared with the squamous carcinoma group (165.26±41.81,123.84±48.01. P=0.000<0.001). the difference was statistically significant. That prompt the protein expression of alpha enolase in malignant pleural effusion group associated with tumor pathological type and further hint that alpha enolase may play an important role in the process of lung adenocarcinoma.