胃泌素释放肽前体和神经元特异性烯醇化酶在小细胞肺癌诊疗中的应用

The clinical significance of pro-gastrin-releasing peptide and neuron specific enolase detection for diagnosis and therapy monitoring in small cell lung cancer patients

目的探讨血清胃泌素释放肽前体(Pro GRP)和神经元特异性烯醇化酶(NSE)在小细胞肺癌(SCLC)临床诊断和疗效监测中的意义。方法分别对2011年9月至2014年1月期间,江门市五邑中医院就诊的41例SCLC患者(LD-SCLC 17例,ED-SCLC 24例)、46例非小细胞肺癌(NSCLC)患者、65例肺良性疾病患者及65名健康体检者的血清Pro GRP和NSE进行化学发光法检测。同时监测41例SCLC患者连续2个周期化疗后的血清Pro GRP和NSE水平变化。结果 SCLC组患者的血清Pro GRP和NSE的中位数水平均显著高于NSCLC组、肺良性疾病组和健康对照组(P均<0.05)。血清Pro GRP单独检测及与NSE联合检测诊断SCLC的敏感度、特异度和ROC-AUC均明显优于血清NSE单独诊断,差异有统计学意义(P<0.05)。连续2个周期化疗后,在LD-SCLC患者和ED-SCLC患者中,血清Pro GRP和NSE水平分别有显著下降(P均<0.05)。结论血清Pro GRP和NSE联合检测在SCLC的临床诊断和疗效监测中具有很大的临床价值。

Objective To study the serum levels of pro-gastrin-releasing peptide（Pro GRP） and neuron specific enolase（NSE） for the clinical diagnosis,therapy monitoring of small lung cancer. Methods Patients and healthy people of Jiang Men Wuyi Traditional Chinese Medicine Hospital form September 2011 to January 2014 were enrolled,including 41 patients with SCLC（LD-SCLC 17 cases,ED-SCLC 24 cases）,46 patients with non-small cell lung cancer（NSCLC）,65 patients with benign pulmonary diseases and 65 healthy people. The serum levels of Pro GRP and NSE were measured by chemiluminescence. The serum levels of Pro GRP,NSE and their changes before and after two cycles of chemotherapy were monitored. Results The serum levels of Pro GRP and NSE in SCLC group were significantly higher than those in NSCLC group, benign pulmonary diseases group and healthy people group（P 〈0.05）. The serum Pro GRP detection and combined with NSE detection compared with NSE individually detection in the diagnosis of SCLC,the sensitivity,specificity and ROC-AUC were significantly better,the difference was statistically significant（P〈0.05）. After two cycles of themotherapy,the serum Pro GRP levels were significantly decreased in the treatment of LD-SCLC patients（P 〈0.05）;the serum NSE levels were significantly decreased in the treatment of ED-SCLC patients（P〈0.05）. Conclusion The combined detection of serum Pro GRP and NSE have important clinical significance in diagnosis and monitoring of SCLC.