神经元特异性烯醇化酶(NSE)在肺癌患者中的分层分析及临床意义

目的:探讨神经元特异性烯醇化酶(neuron specific enolase,NSE)在肺癌患者鉴别诊断及预后判断中的临床意义.方法:回顾分析2014年03月至2016年12月就诊于西安高新医院的334例肺癌患者首次就诊时的血清NSE浓度,分析不同分期肺癌患者NSE浓度、阳性率及阳性患者的临床特征.结果:Ⅰ期和Ⅱ期NSCLC和SCLC患者中,无NSE阳性者.在NSCLC中,Ⅱ-Ⅳ期患者血清NSE浓度比较,差异有统计学意义(P＜0.05);Ⅱ-Ⅳ期患者NSE阳性率两两比较,差异均有统计学意义(P＜0.012 5).在SCLC中,Ⅱ期与Ⅲ期、Ⅳ期与广泛期SCLC患者NSE浓度比较,差异有统计学意义(P＜0.05);Ⅱ期与Ⅲ期、Ⅳ期与广泛期NSE阳性率比较,差异有统计学意义(P ＜0.007 14).结论:NSE不适用于早期肺癌的筛查.无中枢神经或周围神经受侵、其他肿瘤标志物正常时,NSE升高才能用于鉴别SCLC.无论对于NSCLC还是SCLC患者,NSE升高均提示预后不良.

Hierarchical analysis of neuron specific enolase (NSE) in patients with lung cancer and its clinical significance

Objective:To investigate the clinical significance of serum neuron specific enolase(NSE) levels in diagnosis and prognosis of patients with lung cancer.Methods:The clinical data of 334 patients with lung cancer,treated in Xi'an Gaoxin hospital from March 2014 to December 2016,had been collected.The concentrations of serum NSE was detected.The levels and abnormal rate of serum NSE were analyzed according with different stages,and the clinical features of positive cases were further analyzed.Results:There was no positive case in early stage NSCLC and SCLC(stage Ⅰ and stage Ⅱ).There was no statistically significant diffcrence in NSE levels between stage Ⅰ and Ⅱ (P ＞ 0.05).Comparison from stage Ⅱf to Ⅳ,the differences were significant(P ＜ 0.05).Serum NSE abnormal rate were analyzed among Ⅱ-Ⅳ,the differences were statistically significant (P ＜ 0.012 5).In small cell lung cancer patients of stage Ⅰ and Ⅱ,there was no NSE positive case.Their concentration and abnormal rate were analysed,the difference in NSE levels between stage Ⅱ and stage Ⅲ was significant,it also occurred between stage Ⅲ/Ⅳ and extensive cases (P ＜ 0.05).The differences in NSE abnormal rates between stage Ⅱ and stage Ⅲ,stage Ⅳ and extensive cases were significant(P ＜ 0.007 14).Conclusion:NSE is not suitable for early lung cancer screening.Only NSE elevation excluding central nervous system or peripheral nerve invasion is useful for differential diagnosing SCLC.NSE elevation is associated with poor prognosis both NSCLC and SCLC patients.