血清胃泌素释放肽前体对小细胞肺癌的诊断价值

The diagnostic value of serum progastrin-releasing peptide for small cell lung cancer

目的 探讨胃泌素释放肽前体（ProGRP）、神经元特异性烯醇化酶（NSE）、癌胚抗原（CEA）和糖链抗原（CA）19-9在小细胞肺癌患者血清中的水平及其对小细胞肺癌的诊断价值.方法 应用酶联免疫吸附法（ELISA）检测30例小细胞肺癌、30例非小细胞肺癌、15例正常健康体检者的血清ProGRP水平,用电化学发光法测定受试者血清NSE、CEA和CA19-9水平.计算以上4种肿瘤标志物在小细胞肺癌中的阳性率,并用ROC曲线比较对小细胞肺癌的诊断价值.结果 小细胞肺癌组血清ProGRP、NSE水平明显高于非小细胞肺癌组和正常健康组（P〈0.01）,血清CEA、CA19-9水平与非小细胞肺癌组和正常健康组比较差异无统计学意义（P〉0.05）,但非小细胞肺癌组血清CEA水平高于正常健康组（P〈0.05）.血清ProGRP、NSE、CEA和CA19-9在小细胞肺癌诊断中的ROC曲线下面积分别为0.959、0.767、0.617和0.570.血清ProGRP和NSE在小细胞肺癌中的灵敏度分别为96.7%和53.3%,特异度分别为96.7%和46.7%.结论 ProGRP 及NSE均可用于小细胞肺癌的诊断,但ProGRP对小细胞肺癌有更高的诊断价值.

Objective To study serum levels and diagnosis value of progastrin-releasing peptide （ProGRP） ,neuron specific enolase（NSE）,carcino-embryonic antigen（CEA） and carbohydrate antigen （CA19-9） in the patients with small cell lung cancer（SCLC）. Methods 30 newly-diagnosed inpatients with SCLC ,30 newly-diagnosed inpatients with non-small cell lung cancer（NSCLC） and 15 healthy adults served as the control groups. The level of ProGRP in serum were determined by enzymelinked immunosor- bent assay（ELISA）. To detect serum levels of NSE, CEA and CA19-9 through electro-chemiluminescence immunoassay method. Calculating four kinds of serum tumor markers in SCLC positive rate, and comparing diagnosis value of those makers in SCLC through analyzing ROC curve. Results The serum levels of Pro- GRP in SCLC and NSE were significantly higher than these in patients with NSCLC and healthy people（ P 〈0.01 ）,serum levels of CEA, CA19-9 in SCLC group compared with NSCLC and normal health group were no significant difference, but the average serum level s of CEA in NSCLC group was higher than the normal healthy group. The area under the ROC curve of serum ProGRP, NSE, CEA and CA19-9 in SCLC diagnosis were 0. 959,0. 767,0. 617,0. 570. The sensitivity of serum ProGRP and NSE in SCLC were 96.7% and 53.3%, the specificity were 96.7% and 46.7%. Conclusion ProGRP and NSE can be used for the diagnosis of SCLC, but ProGRP is higher diagnostic value in SCLC.