血清ProGRP对小细胞肺癌的诊断和疗效判断价值

Clinical significance of ProGRP in diagnosis of SCLC

目的:探讨胃泌素释放肽前体(ProGRP)对小细胞肺癌(SCLC)的诊断价值。方法:用ELISA的方法检测SCLC患者血清中ProGRP水平,并与神经元特异性烯醇化酶(NSE)对照,观察ProGRP水平与肿瘤分期和治疗效果的关系。结果:ProGRP诊断SCLC的敏感性为75.5%,特异性为82.6%,ProGRP和NSE联合检测的敏感性为88.9%,特异性为52.2%。广泛期SCLC患者血清ProGRP水平高于局限期患者,二者分别为(515.0±310.6)pg/m l和(158.8±102.5)pg/m l(P=0.0003),其差异具有显著性意义。临床治疗有效的SCLC患者,治疗后ProGRP水平较治疗前明显下降,而治疗无效病例则无下降甚至升高。结论:ProGRP作为SCLC的标志物,具有敏感性高、特异性强的特点,并可准确反映SCLC病情及化疗效果。ProGRP和NSE的联合检测是肺癌分型及SCLC早期诊断的较好指标。

Objective： To investigate the significance of serum ProGRP in the diagnosis of small cell lung cancer （SCLC）. Methods： Serum ProGRP level was determined in patients with SCLC, using sandwich enzyme immunoassay and compared with neuron specific enolase （NSE）. Furthermore, its relationship with tumor stage and therapeutic effects was observed. Results： The sensitivity of ProGRP to the diagnosis SCLC was 75.5%, and specificity was 82.6%. The sensitivity of the combined detection of ProGRP and NSE to diagnosis of SCLC was 88.9%, and specificity was 52.2%. The average ProGRP level in the extensive stage of SCLC patients was（515.0 ± 310.6 ）pg/ml, significantly higher than（ 158.8 ± 102. 5 ） pg/ml in the limited stage of SCLC patients with statistical difference （ P = 0.0003 ）. In chemotherapy of sensitive cases, the ProGRP level decreased remarkably after treatment, while there was no change in failure cases. Conclusion： ProGRP is a SCLC tumor marker with high specificity and sensitivity. It has a close relationship with SCLC stage and can be used as a predictor of SCLC to chemotherapy response. The combined measurement of ProGRP and NSE could be a better marker for the histopathological type of lung cancer and early diagnosis of SCLC.