血清pro-GRP、NSE、CEA、ADA检测在肺癌、肺结核鉴别诊断中的意义

目的探讨血清胃泌素释放肽前体（pro-GRP）、神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）、腺苷脱氨酶（ADA）的检测在肺癌和肺结核鉴别诊断中的临床应用价值。方法采用ELISA法检测120例肺癌患者、55例肺结核患者和50例正常对照者血清中pro-GRP、NSE和CEA的水平，应用全自动生化分析仪检测血清中ADA的水平。结果肺癌患者血清中NSE、pro-GRP、CEA的水平分别为（29.5±13.8）ng／ml、（169.2±79.8）pg／ml、（28.6±11.7）ng／ml。均明显高于肺结核组（P〈0.01）；NSE、pro-GRP在小细胞肺癌中的水平[（39.3±13.7）ng／ml，（291.2±217.5）pg/ml]明显高于腺癌[（16.9±7.2）ng／ml，（79.2±48.1）pg／ml]和鳞癌[（15.2±5.3）ng/ml，（81.6±62.1）pg／ml]（P〈0.01）；CEA在腺癌中的水平为（47.2±20.5）ng／ml，明显高于鳞癌[（21.5±9.8）ng/ml]和小细胞肺癌[（18.6±7.5）ng／ml]（P〈0.01）。肺结核患者血清中ADA的水平明显高于肺癌患者（P〈0.01）。结论血清pro-GRP、NSE、CEA、ADA对于肺癌和肺结核的鉴别诊断有一定的临床意义。NSE、pm-GRP二者可作为联合检测小细胞肺癌的标志物组合。

The clinical significance of serum pro-GRP,NSE,CEA and ADA in lung cancer and pulmonary tuberculosis

Objective To evaluate the clinical significance of pro-GRP,NSE,CEA,ADA in differential diagnosis of lung cancer and pulmonary tuberculosis. Methods The level of pro-GRP,NSE,CEA in serum of 120 patients with lung cancer,55 patients with pulmonary tuberculosis and 50 controls were detected by ELISA. The level of ADA in serum was detected by autobiochemical analysis. Results The level of NSE,pro-GRP,CEA [(29.5±13.8)ng/ml, (169.2±79.8)pg/ml, (28.6±11.7)ng/ml]in patients with lung cancer were higher than those of patients with pulmonary tu-berculosis(P < 0.01).The level of the NSE and pro-GRP in patients with small cell lung cancer were higher than those of other subtypes of lung cancers (P < 0.01).The level of the CEA in patients with adenocarcinoma was higher than that of other subtypes of lung cancers (P < 0.01).The level of ADA in patients with pulmonary tuberculosis was higher than that of patients with lung cancer (P < 0.01). Conclusions The detection of pro-GRP,NSE,CEA and ADA in serum are of clinical significance in differential diagnosis of lung cancer and pulmonary tuberculosis. Combination of NSE and pro-GRP is economic in detecting small cell lung cancer.