胃泌素释放肽及其受体预测小细胞肺癌远处转移的价值分析

Analysis of Gastrin-releasng peptide(GRP) and Its Receptor in Forecasting Metastasis of Small Cell Lung Cancer

目的探讨小细胞肺癌肿瘤标志物与预后,远处转移的关系以及预测远处转移的价值。方法回顾性分析73例小细胞肺癌患者临床及病理资料,接受手术治疗者38例(52.1%),局部放疗者35例(47.9%)。用免疫组织化学法检测神经元特异性烯醇化酶(NSE)、胃泌素释放肽(GRP)、胃泌素释放肽受体(GRPR)的蛋白表达,结合肿瘤体积重新分级,分析其与小细胞肺癌患者预后、远处转移的关系。结果 NSE、GRP、GRPR蛋白在小细胞肺癌组织中的阳性表达率分别为71.2%、79.5%、75.3%,GRP与GRPR的表达存在相关性(P=0.000)。GRP、GRPR蛋白不同表达水平患者间的预后及远处转移差异均有统计学意义(P<0.05)。GRP与GRPR蛋白表达预测小细胞肺癌远处转移的敏感度均为71.4%,特异性分别为83.9%、90.3%。结论 GRP、GRPR是敏感度及特异性均较好的预测小细胞肺癌侵袭性及远处转移的重要指标。

Objective To investigate the relationship between tumor marker and prognosis and metastasis of patients with small cell lung cancer （SCLC） and to evaluate the value of tumor marker forecasting the metastasis. Methods Seventy-three patients with SCLC were retrospectively analyzed. Thirty-eight （52. l %） patients received surgery, and 35 （47. 9 % ） received local radiotherapy. All patients paraffinembedded tumor tissues were obtained and the expressions of NSE, GRP, and GRPR were checked by immunohistochemistry. Combined with tumor volumes, the expressions were re-classified and analyzed with progrosis and distant metastasis of patients with small cell lung cancer. Results The positive ex- pression rates of NSE, GRP and GRPR protein in small cell lung cancer were detected as 71.2%, 79.5%, and 75.3%, respectively, of all tumor specimens. The expression of GRP was correlated to that of GRPR significantly （P = 0. 000）. The expression of GRP and GRPR were associated with patients＇ prognosis and metastasis significantly （P〈0. 05）. The sensitivity of the expression of GRP and GRPR forecasting the metastasis was both 71.4%, and the specificity of them was 83. 9% and 90. 3, respective- ly. Conclusion GRP and GRPR may be an important tumor marker forecasting the invasion and metasta- sis of small-cell lung cancer.