小细胞肺癌患者血清胃泌素释放肽前体的临床意义研究

Study on the clinical significance of serum pro-gastrin-releasing peptide for small cell lung cancer patients

目的:以神经特异性烯醇化酶作对照,探讨血清胃泌素释放肽前体检测对小细胞肺癌的临床意义。方法:采用酶联免疫吸附实验检测62例小细胞肺癌患者血清胃泌素释放肽前体和神经特异性烯醇化酶,应用SA S统计软件进行统计学分析。结果:37例初治患者血清胃泌素释放肽前体的上升幅度较神经特异性烯醇化酶大,其差别具有统计学意义(P<0.05);广泛期患者血清胃泌素释放肽前体的水平高于局限期,但差异没有统计学意义(P>0.05),神经特异性烯醇化酶亦然;复治组中,广泛期患者血清胃泌素释放肽前体水平显著高于局限期,差异具有统计学意义(P<0.05);血清胃泌素释放肽前体的升高幅度与神经特异性烯醇化酶相比,差异不具统计学意义(P>0.05)。在38例治疗有效后再次复发患者,血清胃泌素释放肽前体随病情变化而变化的幅度比神经特异性烯醇化酶大,差异具有统计学意义(P<0.05);血清胃泌素释放肽前体在治疗有效时明显下降,复发时再次升高,三个不同阶段的差异具有统计学意义,神经特异性烯醇化酶亦然(P<0.05)。治疗有效或病情进展时,血清胃泌素释放肽前体和神经特异性烯醇化酶都随之明显降低或升高,两指标在治疗前后水平的差异均有统计学意义(P<0.01);且血清胃泌素释放肽前体的变化幅度较神经特异性烯醇化酶大,差异有统计学意义(P<0.01);在治疗后病情稳定患者,血清胃泌素释放肽前体和神经特异性烯醇化酶变化都不大,差异均无统计学意义(P>0.05)。结论:血清胃泌素释放肽前体在病情监测、疗效评价、治疗效果预测方面优于神经特异性烯醇化酶。

Objective To evaluate the clinical significance of serum pro-gastrin-releasing peptide for diagnosis, treatment and monitoring of patients with small cell lung cancer in contrast with that of serum neuron-specific enolase. Methods The fragments of serum pro-gastrin-releasing peptide and neuron-specific enolase were determined with ELISA method in 62 small cell lung cancer patients. The statistical analyses were performed by SAS statistical software. Results For 37 previously untreated patients, the extent of serum pro-gastrin-releasing peptide rise was larger than neuron- specific enolase （P〈0. 05）, and there was no significant difference between extended and limited stages（P^0.05）. Serum pro-gastrin-releasing peptide levels of patients who had had prior therapy in extended stage were markedly higher than those in limited stage（P〈0.05）. The degree of serum pro-gastrin-releasing peptide elevation was higher than neuron-specific enolas, but there was no significant difference（P〉0.05）. At the same time,serum pro-gastrin-releasing peptide and neuron- specific enolase levels were analyzed in relapsed patients, and the variation extent of serum pro-gastrin-releasing peptide on the basis of patients state was larger than neuron-specific enolase, and showed marked difference （P 〈 0. 05）. Furthermore, there was statistical difference among the different stages of therapy （P 〈 0. 05）. Patients who achieved objective response or reacted unsuccessfully showed significant drop or elevation of serum pro-gastrin-releasing peptide and neuronspecific enolase levels（P〈0.01）. As shown in the data, the difference between the elevation degrees of serum pro-gastrin-releasing peptide and neuron-specific enolase among these patients was prominent, too（P〈0.01）. But for those stable cases,there was no remarkable difference（P〉0.05）. Conclusion Serum pro-gastrin-releasing peptide is more valuable as a tumor marker for treatment and monitoring of small cell lung cancer patients than neuron-specific enolase.