Küstner W, Bernhardt S, Lützen C, Ritter U
Med Klin. 1976 Feb 20;71(8):323-32.
The question if combined routine-laboratory-tests could improve the search for malignomas in man was checked by comparison of 519 patients with carcinoma and 460 patients with other diseases. In order to do so a combination of four (erythrocyte sedimentation rate, alkaline phosphatase, red blood-picture, relative alpha-2-globuline-increase) and five (additionally alpha-1-globuline-increase) was put up. For either group the found constellations - consisting of normal and pathological items - and their sensibility and specificity were set up. To find out their diagnostical value the likelihood-ratio was determined. Those combinations with exclusively pathological results of all four respectively five laboratory reports and the linked symptoms "anemia - relative alpha-2-globuline-increase" showed to be of high differential diagnostical value. In these groups the probability of malignoma was found to be 4,6:1, 8:1, 3,2:1. The serum protein dispersion of a group of patients with benigne and maligne diseases of the digestive tract was additionally checked by means of the paper-electrophoresis. Those changes that showed a relative increase of all globuline-fractions combined with a decrease of serum albumins under 45% was almost exclusively found in patients with malignomas. All-together this paper shows that certain pathological laboratory-tests--if found together in one patient--give a grave indication for the presence of malignoma.
通过比较519例癌症患者和460例患有其他疾病的患者,来检验联合常规实验室检查是否能改善对人类恶性肿瘤的筛查。为此,提出了四项检查(红细胞沉降率、碱性磷酸酶、红细胞图像、相对α-2球蛋白增加)和五项检查(另外加上α-1球蛋白增加)的组合。针对每组,确定由正常和病理项目组成的检查结果组合及其敏感性和特异性。为了确定它们的诊断价值,计算似然比。所有四项或五项实验室报告结果均为病理性且伴有“贫血-相对α-2球蛋白增加”相关症状的组合显示出较高的鉴别诊断价值。在这些组中,发现患恶性肿瘤的概率为4.6:1、8:1、3.2:1。另外,通过纸电泳检查了一组患有消化道良性和恶性疾病患者的血清蛋白电泳。所有球蛋白组分相对增加且血清白蛋白减少至45%以下的变化几乎仅在恶性肿瘤患者中发现。总体而言,本文表明某些病理实验室检查——如果在一名患者中同时出现——强烈提示存在恶性肿瘤。