血清ProGRP、NSE、CYFRA21-1联合检测对肺癌诊断和治疗的临床意义

Clinical significance of tumor marker ProGRP,NSE,CYFRA21-1 in lung cancer

目的:探讨ProGRP、NSE、CYFRA21-1联合检测在肺癌诊断和治疗中的临床意义。方法:用电化学发光和ELISA的方法检测血清ProGRP、NSE、CYFRA21-1的含量。结果:肺癌组血清ProGRP、NSE、CYFRA21-1水平均明显高于健康人组和肺良性疾病组,差异有统计学意义(P<0.01)。NSE、ProGRP在小细胞肺癌中的水平明显高于其他类型的肺癌(P<0.01),CYFRA21-1在鳞癌中的水平明显高于其他类型的肺癌(P<0.01)。临床治疗有效的SCLC患者,治疗后ProGRP、NSE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、NSE、CYFRA21-1对肺癌的辅助诊断有较高的临床价值。NSE、ProGRP二者可作为联合检测小细胞肺癌的首选标志物,动态检测可指导治疗,提示预后。CYFRA21-1可作为检测肺鳞癌的首选标志物,且能反映病情和治疗效果。

Objective：To study the clinical significance of serum ProGRP, NSE, CYFRA21 - 1 in the diagnosis and treatment of lung cancer. Methods：Serum ProGRP, NSE, CYFRA21 - 1 were detected using sandwich enzyme immunoassay and electrochemiluminescence immunoassay respectivelycompared with NSE. 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 extensive disease of SCLC patients was （515.0 ± 310. 6） pg/ ml, significantly higher than （ 158.8 ± 102. 5 ） pg/ml in limited disease of SCLC patients. The two values had statistical difference （ P = 0. 0003 ）. In chemotherapy sensitive cases, the ProGRP level decreased remarkably after treatment, while there was no change in failure cases. Condusion：ProGRP is a SCLC tumor marker with high specifity 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 histopathological type of lung cancer and early diagnosis of SCLC.