联合检测血清胃泌素释放肽前体和特异性组织多肽抗原在小细胞肺癌诊断中的临床价值

The clinical value of combined measurement of serum ProGRP and TPS in diagnosing small-cell lung cancer

目的:探讨联合检测血清胃泌素释放肽前体(ProGRP)和组织多肽特异性抗原(TPS)在小细胞肺癌(SCLC)诊断中的临床意义。方法:采用ELISA法测定93例SCLC患者、63例肺良性疾病患者和62例正常对照组的ProGRP和TPS水平,并对其结果进行比较。结果:SCLC组患者血清ProGRP、TPS水平[(436.4±765.8)ng/ml、(367.8±518.7)U/L]显著高于肺良性疾病组[(21.7±9.5)ng/ml、(101.1±45.1)U/L]和正常对照组[(17.3±9.5)ng/ml、(85.6±37.4)U/L](P<0.01),SCLC组患者血清ProGRP、TPS水平Ⅲ、Ⅳ期显著高于Ⅰ、Ⅱ期(P<0.01),ProGRP和TPS诊断SCLC的敏感性分别为67.5%和59.4%,特异性分别为97.6%和82.4%。Ⅲ、Ⅳ期(79.6%,83.7%)ProGRP和TPS诊断SCLC的敏感性均明显高于Ⅰ、Ⅱ期(50%,52.9%)。联合检测ProGRP和TPS敏感性和特异性分别为81.9%和80%。治疗前ProGRP和TPS水平[(604.4±637.3)ng/ml、(538.3±650.5)U/L]分别是治疗后[(141.5±179.1)ng/ml、(275.2±269.9)U/L]的4.27倍和1.96倍,治疗前ProGRP、TPS和治疗后比较有显著差异(P<0.05),治疗效果明显。结论:ProGRP作为一种新的SCLC肿瘤标志物,对SCLC诊断敏感、特异,ProGRP比TPS具有更高的特异性,同时检测,起到优势互补的作用,有助于提高SCLC早期的阳性检出率,减少漏诊率,对判别病情变化及疗效有重要作用。

Objective：To study the clinical significance of serum progastrin -releasing -peptide （ProGRP） and tissue polypeptide specific antigen （TPS） level in diagnosing the small -cell lung cancer（ SCLC ）. Methods：Serum level of ProGRP and TPS was measured by ELISA in 93 patients with SCLC ,63 patients with benign lung disease and 62 normal subjects. Results：The average level of ProGRP and TPS was significantly increased in patients with SCLC [ （436.4 ± 765.8 ）ng/ml, （367.8 ± 518.7） U/L ] than patients with benign disease [ （21.7 ±9.5 ） ng/ml, （101.1 ±45.1） U/L] and normal subjects[ （17.3 ±9.5）ng/ml,（85.6 ±37.4）U/L] （P 〈0.01）. Serum level of ProGRP and TPS of patients with SCLC in stage Iil, IV was evidently higher than that of patients with SCLC in stage Ⅰ , Ⅱ （P 〈0.01 ）. The sensitivity of ProGRP and TPS to diagnose SCLC was 67.5% and 59.4% respectively, the specificity was 97.6% and 82.4% , respectively. The sensitivity of ProGRP and TPS in stage Ⅲ, Ⅳ（ 79.6% , 83.7% ） was higher than that in stage Ⅰ, Ⅱ（50% ,52.9% ）. The sensitivity and specificity of combined measurement of ProGRP and TPS was 81.9% and 80%. The average level of ProGRP and TPS before therapy[ （604.4 ±637.3） ng/ml, （538.3 ±650.5） U/L] was 4.27 times and 1.96 times than that of after therapy[ （ 141.5 ±179.1 ） ng/ml, （275.2 ±269.9 ） U/L ] , there was evident difference about the level of ProGRP and TPS before and after therapy（P 〈 0. 05）,so the curative effect was evident. Conclusion：As a new tumor marker, ProGRP has higher specificity than TPS. The combined measurement of ProGRP and TPS will enhance positive detection rate for diagnosing SCLC, and is helpful for judging stage and curative effect.