小细胞肺癌血清ProGRP（31—98）与神经元性烯醇化酶同步检测的临床价值及其相关性

Clinical values and relativity of NSE and ProGRP （31-98） in patients with small-cell lung cancer

目的探讨小细胞肺癌（SCLC）患者血清神经元性烯醇化酶（NSE）与ProGRP（31-98）水平同步检测的临床价值及其相关性。方法采用酶联免疫吸附法（ELISA）对159例SCLC患者、97例肺部良性疾病患者、100名健康人进行血中ProGRP（31—98）与NSE水平的检测。结果SCLC治疗前NSE与ProGRP（31—98）的中位值分别为21．33μg／L和323．70pg／ml，肺部良性疾病分别为4．24μg／L和11．94Pg／ml，健康人分别为5．82μg／L和8．54Pg／ml，3组间比较差异均有统计学意义（均P〈0．001）；以NSE10．35ng／L和ProGRP（31-98）47．98Pg／ml为界值，敏感度分别为71．1％和88．7％，特异度分别为95．5％和96．9％，两项联合检测的敏感度和特异度分别为95．6％和96．8％。SCLC局限期和广泛期NSE中位值分别为14．75μg／L和34．10μg／L，敏感度分别为51．14％和93．44％，ProGRP（31—98）中位值分别为143．14Pg／ml和1061．14Pg／ml，敏感度分别为80．61％和98．61％。治疗后缓解和部分缓解的患者两项血清水平较治疗前明显下降，差异有统计学意义（P〈0．001），未缓解和进展期的患者治疗前后无明显变化。SCLC患者NSE和ProGRP（31-98）血清水平的检测有显著相关性（r=0．379，P〈0．01）。结论NSE和ProGRP（31—98）血清水平有明显的相关性，作为SCLC治疗前诊断和疗效观察均有一定的指导意义，但ProGRP（31．98），特别是对早期SCLC的诊断有更好的敏感性和准确度，两项联合可进一步提高检测的阳性率和有效性。

Objective To study the clinical values and relativity of serum levels of NSE and ProGRP （P31-98） in patients with small-cell lung cancer. Methods Serum levels of NSE and ProGRP （31-98） was measured by ELISA in 159 patients with small cell lung cancer（SCLC）, 99 patients with benign lung diseases, and 100 healthy subjects, 141 SCLC patients before and after treatment were also measured. Results The medians of NSE and ProGRP （31-98） was 21.33μg/L and 323.70 pg/ml in patients with SCLC, 4.24 μg/L and 11.94 pg/ml in patients with benign lung diseases, 5.82 μg/L and 8.54 pg/ml in healthy subjects respectively, significantly increased in patients with SCLC as compared to that of the other two groups （P 〈0.01）. Given the cut-off levels of 10.35 μg/L for NSE and 47.98 pg/ml for ProGRP（31-98）, the sensitivity of diagnosis in SCLC was 71.1% and 88.7 %, respectively. The combination sensitivity and specificity of NSE and ProGRP（31-98） was 95.6 % and 96.8 %. The medians of NSE in SCLC patients with extensive and limited disease was 14.75μg/L and 34.10 μg/L, the sensitivity was 51.14 % and 93.44 %, respectively; ProGRP （31-98） in the two groups was 143.14 pg/ml and 1061.14 pg/ml, 80.61%and 98.61%, respectively. In SCLC patients with remission after treatment the levels of NSE and ProGRP31-98 was significantly lower than that before treatment, but the levels without remission had no significantly change. There was significant relationship between NSE and ProGRP（31-98） in serum levels of patients with SCLC （r =0.379, P 〈0.01）. Conclusion The serum levels of NSE and ProGRP （31-98） in patients are both increased, there are a significant relationship. But ProGRP（31-98） is a more specific and sensitive marker than NSE for the diagnosis of SCLC. The combination of the two markers can improve positive rate and validity.