血清胃泌素释放肽前体在小细胞肺癌中的临床价值

目的探讨胃泌素释放肽前体(Pro-GRP)在小细胞肺癌(SCLC)诊断和治疗监测中的价值。方法检测96例SCLC患者(SCLC组,其中局限期74例、广泛期22例)、63例非小细胞肺癌(NSCLC)患者(NSCLC组)和76名体检健康者(正常对照组)的血清Pro-GRP、癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)水平。96例SCLC患者中有86例患者完成1个疗程的化疗。结果 SCLC组血清Pro-GRP、NSE水平均高于正常对照组和NSCLC组(P<0.001)。SCLC组和NSCLC组血清SCC-Ag水平高于正常对照组(P<0.001)。NSCLC组血清CEA、CYFRA21-1水平均高于正常对照组和SCLC组(P<0.001)。广泛期SCLC患者血清Pro-GRP水平高于局限期SCLC患者(P<0.01)。SCLC患者化疗后血清Pro-GRP、NSE水平低于化疗前(P<0.001)。ROC曲线分析结果显示,Pro-GRP和NSE诊断SCLC的曲线下面积(AUC)分别为0.960、0.849,最佳临界值分别为76.31ng/L、13.87ng/mL,敏感性分别为84.5%、77.6%,特异性分别为98.6%、79.5%。结论 Pro-GRP在SCLC的诊断、临床分期和治疗监测中均有一定的价值。

Role of serum pro-gastrin releasing peptide in patients with small cell lung cancer

Objective To investigate the role of serum pro-gastrin-releasing peptide(Pro-GRP)in the diagnosis and treatment of small cell lung cancer(SCLC).Methods The levels of serum Pro-GRP,carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC-Ag),cytokeratin 19-fragment(CYFRA21-1)and neuron specific enolase(NSE)in 96 patients with SCLC(74 patients with limited SCLC and 22 patients with extensive SCLC),63 patients with non-small cell lung cancer(NSCLC)and 76 healthy subjects(healthy control group)were determined.A total of 86 of 96 SCLC patients completed 1 cycle of chemotherapy.Results Compared with healthy control group and NSCLC group,the levels of Pro-GRP and NSE in SCLC group increased(P<0.001),and serum SCC-Ag levels in SCLC group and NSCLC group were higher than that in healthy control group(P<0.001).The levels of CEA and CYFRA21-1 were higher in NSCLC group than those in healthy control group and SCLC group(P<0.001).The Pro-GRP level in patients with limited SCLC was lower than that in patients with extensive SCLC(P<0.01).Pro-GRP and NSE were lower in SCLC patients after chemotherapy(P<0.001).Receiver operating characteristic(ROC)curve showed that the sensitivity of Pro-GRP in diagnosing SCLC was 84.5%,and the specificity was 98.6%,which were higher than those of NSE in diagnosing SCLC(77.6%,79.5%,respectively).The areas under curves(AUC)of Pro-GRP and NSE were 0.960 and 0.849,respectively. The optimal cut-off values were 76.31 ng/L and 13.87 ng/mL,respectively. Conclusions Serum Pro-GRP is of significance in the diagnosis,clinical staging and treatment monitoring of SCLC.