DIAGNÓSTICO DE DIFERENCIAÇÃO NEUROENDÓCRINA NO LÍQUIDO PLEURAL ATRAVÉS DO MARCADOR MOLECULAR CITOPLASMÁTICO ENOLASE NEURÔNIO ESPECÍFICA

• Autor(a) principal: Silva Junior, Cyro Teixeira da
• Data de Publicação: 2009
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Federal Fluminense (RIUFF)
• Texto Completo: https://app.uff.br/riuff/handle/1/18407
• topic: Marcador molecular citoplasmático; Enolase; Fosfopiruvato hidratase; Derrame pleural; Marcador biológico de tumor; Cytoplasmic molecular markers, enolase; pleural effusion; biological marker of tumor; CNPQ::CIENCIAS BIOLOGICAS::IMUNOLOGIA

Neuron-specific enolase (NSE) is a glycolytic enzyme involved in the glycolysis pathway. Assays to evaluate the presence of NSE in lung cancer have been widely investigated and its presence defines neuroendocrine differentiation. However, their diagnostic values have not yet been clarified in pleural fluids (PFs). Objective: To determine the usefulness of NSE in PFs (L-NSE) in malign pleural effusion and its differentiation from benign effusions. Method: Time-resolved immunofluorometric assay (TRF). Results: The enzyme levels were evaluated in seventy patients with benign and malignant PFs. Twenty patients with malignant pleurisy due to non-small cell lung cancer or NSCLC (n=15), lymphomas (n=4) and neuroblastoma (n=1). Fifty control patients with benign PFs with miscellaneous causes, mainly tuberculosis (33.0%). The group of malign pleural effusion was 9 men and 11 women with average age of 67. 6 years (35 to 92 years). Benign PFs were comprised of 30 men and 20 women with an average age of 49 years (3 to 94 years). The mean level of L-NSE was higher in malign pleural effusions (38.5 ± 54.9µg/L) than in patients with benign pleural effusions (9.35 ± 23.7µg/L). Two tail p value was statistically significant (p=0.0304). Kruskal-Wallis test with post hoc procedures compared three unpaired groups. It was statistically significant (H=9.998; p=0.0067). Post-Hoc Dunn's test revealed a significant difference of benign group versus NSCLC group (p<0.01) but not lymphomas versus benign group (p>0.05) and lymphomas versus NSCLC (p>0.05). L-NSE levels 28,5 µg/L in malignant pleurisy showed a sensitivity of 30,0 %, a specificity of 96,0 %, a positive predictive value of 75,0 %, a negative predictive value of 77,0 %, a positive likelihood of 7,5 a negative likelihood of 0,32 and a test accuracy of 77,1. Conclusion: L-NSE is useful to differentiate malignant from benign pleurisy.