血清胃泌素前体释放肽片断31—98和神经元特异性烯醇化酶水平与肺癌不同病理组织学类型的关系及其临床意义

The clinical value and relationship between the serum levels of Pro-gastrin-releasing peptide 31-98 （Pro- GRP）, neuron-specific enolase and the different pathohistology types of lung cancer.

目的探讨血清胃泌素前体释放肽片断31-98（ProGRP）、神经元特异性烯醇化酶（NSE）水平与肺癌不同病理组织学类型的关系及其临床应用价值。方法将明确病理组织学分型的353例肺癌患者分为2组：小细胞肺癌（SCLC）组96例，非小细胞肺癌（NSCLC）组257例，并以90例肺部良性病变作为对照组，采用酶联免疫吸附实验对所有患者进行血清ProGRP及NSE检测，比较肺癌与肺部良性病变患者之间及不同病理组织学类型肺癌患者之间血清ProGRP、NSE水平其临床应用价值。结果SCLC组、NSCLC组血清ProGRP、NSE水平均明显高于肺部良性病变组（P均〈0．01）；血清ProGRP单项检测诊断SCLC的敏感度、特异度、Youden指数和Kappa值，分别为0．7708、0．9444、0．7153和0．7111，血清NSE单项检测诊断SCLC的敏感度、特异度、Youden指数和Kappa值，分别为0．7604、0．8778、0．6382和0．6355；血清ProGRP＋NSE联合检测（序列试验）诊断SCLC的敏感度、特异度、Youden指数和Kappa值，分别为0．7604、0．9667、0．7271和0．7221；血清ProGRP＋NSE联合检测（平行试验）诊断SCLC的敏感度、特异度、Youden指数和Kappa值，分别为0．8229、0．9000、0．7229和0．7209。血清ProGRP、NSE单项及联合检测诊断NSCLC的敏感度、特异度、Youden指数和Kappa值均较低。结论在SCLC的诊断中，血清PmGRP检测优于NSE，血清ProGRP＋NSE联合检测（平行试验）及ProGRP＋NSE联合检测（序列试验）优于血清ProGRP或NSE单项检测，血清Pro—GRP＋NSE联合检测（平行试验）优于血清ProGRP＋NSE联合检测（序列试验）。血清ProGRP及NSE单项及联合检测对NSCLC的诊断价值不大。

Objective To evaluate the clinical value and relationship between the serum levels of the Progastrin-releasing peptide 31-98 （ProGRP） , neuron-specific enolase NSE and the different pathohistology types of lung cancer. Methods 353 lung cancer patients were divided into two groups according to pathohistology types： SCI,C group（ n = 96）, NSCLC group（ n = 257）. 90 lung benign lesion were taken as control group. ProGRP and neuron specific enolase in all patients were detected by EI3SA. The levels of the ProGRP,NSE and the clinical value were compared among lung cancer,lung benign lesion patients and the different pathohistology types of lung cancer patients . Results The levels of the ProGRP and NSE of SCLC and NSCLC group were higher obviously than that of lung benign lesion（ P 〈0.01 ）. In SCLC diagnosis, the sensitivity, specificity, Youden index and Kappa value of the ProGRP and NSE were 0.7708,0. 9444,0.7153,0.7111 and 0. 7604,0. 8778,0. 6382,0. 6355 in the monomial detection ; Those indexes above were 0.7604,0. 9667,0. 7271 and 0. 7221 in combined assay of ProGRP ＋ NSE（ on sequence test） ; and were 0. 8229,0. 9000,0. 7229 and 0. 7209 in combined assay of ProGRP ＋ NSE（ on parallell test）. In NSCI,C diagnosis,the above indexes were all lower. Conclusions In SCI.C diagnosis,the detection of the serum ProGRP is superior to the detection of NSE,the combined assay of ProGRP ＋ NSE（ on parallell lest） and Pro- GRP ＋ NSE（on sequence test） are superior to the monomial detection of the ProGRP or NSE,and the combined assay of ProGRP ＋ NSE（ on parallell test） is superiro to ProGRP ＋ NSE（ on sequence test） ; The diagnosis value of the monomial and united detection of ProGRP and NSE to NSCI,C is not as expected.