联合检测Pro-GRP、NSE、CYFRA21-1和PCT在SCLC中诊断和疗效评估中的价值

The Value of Diagnostic and Therapeutic Surveillance with Combined Detection of Pro-GRP,NSE,CYFRA21-1 and PCT in Small Cell Lung Cancer

目的:探讨联合检测胃泌素释放肽前体(Pro-GRP)、神经元特异烯醇化酶(NSE)、细胞角蛋白19片段抗原(CYFRA21-1)和降钙素原(PCT)水平在小细胞肺癌(SCLC)中的诊断和治疗监测的价值。方法:通过查询医院病案系统回顾性分析2021年5月至2022年12月收治的328例SCLC患者(SCLC研究组)和300例同期在医院治疗的非小细胞肺癌(NSCLC)患者(NSCLC对照组)及80例肺良性疾病的体检者(良性疾病对照组)。收集所有受试者血清Pro-GRP、NSE、CYFRA21-1和PCT水平检验结果,比较三组血清Pro-GRP、NSE、CYFRA21-1、PCT水平,比较SCLC研究组不同分期、不同预后组Pro-GRP、NSE、CYFRA21-1及PCT水平,采用受试者工作特征(ROC)曲线分析对SCLC的诊断效能。结果:SCLC研究组血清Pro-GRP、NSE、和PCT水平均显著高于良性疾病对照组和NSCLC对照组(P<0.05);SCLC研究组CYFRA21-1水平低于NSCLC对照组(P<0.05);Ⅲ+Ⅳ期SCLC患者血清Pro-GRP、NSE、CYFRA21-1和PCT水平均显著高于Ⅰ+Ⅱ期SCLC患者(P <0.05);CR+PR组SCLC患者化疗后血清Pro-GRP、NSE、CYFRA21-1和PCT水平均显著低于化疗前(P<0.05);SD组SCLC患者化疗后血清Pro-GRP、NSE、CYFRA21-1和PCT水平与化疗前比较,差异无统计学意义(P>0.05);PD组SCLC患者化疗后Pro-GRP、NSE显著高于化疗前(P<0.05),CYFRA21-1和PCT水平与化疗前比较,差异无统计学意义(P>0.05);联合检测Pro-GRP、NSE、CYFRA21-1和PCT的灵敏度、特异度、准确度、阳性预测值和阴性预测值高于单项检测。结论:联合检测Pro-GRP、NSE、CYFRA21-1和PCT水平可提高SCLC患者诊断效能,监测SCLC患者化疗前后Pro-GRP、NSE、CYFRA21-1和PCT水平变化有助于患者化疗后疗效判断及预后评估。

Objective:To investigate the value of combined detection of progastrin releasing peptide(Pro-GRP),neuron specific enolase(NSE),Cytokeratin 19 fragment antigen(CYFRA21-1)and procalcitonin(PCT)levels in the diagnosis and therapeutic surveillance of small cell lung cancer(SCLC).Method:A retrospective analysis was conducted on 328 SCLC patients(SCLC study group),300 non-small cell lung cancer(NSCLC control group)patients who were treated in the hospital during the same period(NSCLC control group),and 80 healthy lung disease examiners(benign disease control group)admitted from May 2021 to December 2022 by querying the hospital medical record system.Collected the test results of serum Pro-GRP,NSE,CYFRA21-1 and PCT levels from all subjects,compared the levels of Pro-GRP,NSE,CYFRA21-1 and PCT in three groups,and compare the levels of Pro-GRP,NSE,CYFRA21-1 and PCT in different stages and prognosis groups of the SCLC study group. Used the receiver operating characteristic (ROC) curve to analyze the diagnostic efficacy of SCLC. Result: The serum Pro-GRP, NSE and PCT levels in the SCLC study group were significantly higher than those in the benign disease control group and NSCLC control group(P<0.05). The level of CYFRA21-1 in the SCLC study group was lower than that in the NSCLC control group(P<0.05). The serum levels of Pro-GRP, NSE, CYFRA21-1 and PCT in patients with stage Ⅲ+Ⅳ SCLC were significantly higher than those in patients with stage Ⅰ+Ⅱ SCLC(P<0.05);Serum of SCLC patients in the CR+PR group after chemotherapy. The levels of Pro-GRP, NSE, CYFRA21-1 and PCT were significantly lower than before chemotherapy(P<0.05);There was no statistically significant difference in the levels of Pro-GRP, NSE, CYFRA21-1 and PCT in the serum of SCLC patients in the SD group after chemotherapy compared to before chemotherapy(P>0.05). The Pro-GRP and NSE levels of SCLC patients in the PD group were significantly higher after chemotherapy than before(P<0.05), while the levels of CYFRA21-1 and PCT were not statistically significant compared to before chemotherapy(P>0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the combined detection of Pro-GRP, NSE, CYFRA21-1 and PCT were higher than those of individual tests. Conclusions: The combined detection of Pro-GRP, NSE, CYFRA21-1 and PCT levels can improve the diagnostic efficiency of SCLC patients, and the monitoring of Pro-GRP, NSE, CYFRA21-1 and PCT levels before and after chemotherapy is helpful for the judgment of efficacy and prognosis of patients after chemotherapy.