Hillerdal G, Lindqvist U, Engström-Laurent A
Department of Pulmonary Medicine, Akademiska Hospital, University of Uppsala, Sweden.
Cancer. 1991 May 1;67(9):2410-4. doi: 10.1002/1097-0142(19910501)67:9<2410::aid-cncr2820670933>3.0.co;2-d.
It has been suggested that a high level of hyaluronan (hyaluronic acid, HYA) in pleural fluid is an indicator of malignant mesothelioma. In 78 consecutive patients with pleural effusion of various causes the HYA concentration was measured in pleural fluid samples and in serum. Nine patients had malignant pleural mesothelioma, and in three of them the HYA level in pleural fluid was 100 mg/l or more. In 42 patients with effusions due to metastatic malignancy, the mean HYA in the pleural fluid was 75 mg/l, and in five the HYA level was above 100 mg/l. Cardiac insufficiency caused the effusion in 11 patients, of whom two had a level above 100 mg/l in pleural fluid. Four patients had a serologically confirmed viral infection and had HYA levels in pleural fluid of 8, 157, 335, and 554 mg/l, respectively. One patient had postinfectious effusion with an HYA level in pleural exudate of 748 mg/l, the highest in this investigation. Two patients had benign asbestos pleural effusions, and both had high pleural HYA levels (256 and 490 mg/l, respectively). The serum HYA values were much lower than in the pleural fluid, namely from 15 to 480 micrograms/l; the levels were independent of the levels in the pleural fluid. Thus, a high level of HYA in pleural fluid is not specific for mesothelioma but can occur in other malignant or benign diseases, and a low level does not exclude mesothelioma.
有人提出，胸腔积液中高水平的透明质酸（HA）是恶性间皮瘤的一个指标。在78例连续的各种原因引起胸腔积液的患者中，对胸腔积液样本和血清中的HA浓度进行了测量。9例患者患有恶性胸膜间皮瘤，其中3例胸腔积液中的HA水平为100mg/l或更高。在42例因转移性恶性肿瘤导致胸腔积液的患者中，胸腔积液中的平均HA为75mg/l，5例患者的HA水平高于100mg/l。11例患者因心力衰竭导致胸腔积液，其中2例胸腔积液中的HA水平高于100mg/l。4例患者经血清学确诊为病毒感染，胸腔积液中的HA水平分别为8、157、335和554mg/l。1例患者有感染后胸腔积液，胸腔渗出液中的HA水平为748mg/l，是本研究中最高的。2例患者有良性石棉性胸腔积液，二者胸腔HA水平均较高（分别为256和490mg/l）。血清HA值远低于胸腔积液中的值，即15至480μg/l；其水平与胸腔积液中的水平无关。因此，胸腔积液中高水平的HA并非间皮瘤所特有，也可出现在其他恶性或良性疾病中，而低水平也不能排除间皮瘤。
