[Assessment of erythrocyte pyrimidine 5'-nucleotidase test for screening of occupational lead poisoning].
OBJECTIVE
To determine the diagnostic value of red cell P5'-N for detecting occupational lead poisoning.


METHODS
Red cell pyrimidine 5;-nucleotidase, blood lead and urine lead levels, free erythrocyte protoporphyrin (FEP), zinc protoporphyrin (ZPP) and urine delta-aminolevulinic acid levels were determined in 157 lead exposed workers and 30 non-exposed healthy people. According to the golden standard; i.e. blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the diagnostic value of red cell P5'N and other indicators for detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L was compared by receiver operative characteristic curve (ROC) software. After determining the optimal cut-points of the above indicators for detecting the blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the sensitivity of the parallel tests for detecting the blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L was calculated and compared by EPINFOR software.


RESULTS
For detecting blood lead level >/= 1.93 micromol/L, the areas under ROC curve (AUC(ROC)) of P5'N was significantly larger than that of urinary lead and urinary delta-ALA (P < 0.05). The sensitivity of parallel tests with ZPP and P5'N was significantly larger than that of parallel tests with Upb and Udelta-ALA. For detecting blood lead level >/= 2.90 micromol/L, the areas under ROC curve (AUC(ROC))of P5'N was significantly larger than that of urinary lead, FEP and urinary delta-ALA (P < 0.05). The sensitivity of parallel tests with P5'N and ZPP was significantly larger than that of parallel tests with Upb and Udelta-ALA, and that of parallel tests with ZPP and FEP (P < 0.05).


CONCLUSIONS
For detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, red cell P5'N is more accurate. It is worth being applied in detecting occupational lead poisoning. For detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the parallel tests with P5'N and ZPP are more accurate.
Lü
L
L
Shanghai Medical University, Shanghai 200040, China.
Lin
G
G
Wang
Q
Q
D015720:5'-Nucleotidase / Q000032:analysis*; D000328:Adult; D000622:Aminolevulinic Acid / Q000652:urine; D004912:Erythrocytes / Q000201:enzymology*; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood / Q000652:urine; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011524:Protoporphyrins
D011524:Protoporphyrins; C017803:zinc protoporphyrin; D007854:Lead; D000622:Aminolevulinic Acid; D015720:5'-Nucleotidase