助力于小细胞肺癌诊断的血清肿瘤标志物

Serum Tumor Markers Help to Diagnosis and Recurrence of Small Cell Lung Cancer

目的:探讨血清胃泌素释放肽前体(Pro GRP)诊断、监测、评估、预后判断小细胞肺癌(SCLC)的临床价值。方法:选取2012年7月-2014年8月于笔者所在医院诊断治疗的86例小细胞肺癌患者作为研究对象,同期选取非小细胞肺癌患者75例,其他良性肺部疾病患者45例。采用电化学发光法对治疗前后肺癌患者和其他肺部疾病患者的血清神经元特异性烯醇化酶(NSE)、Pro GRP、CYFRA21-1、癌胚抗原(CEA)水平进行检测,同时肺癌患者还进行相关影像学检查。结果:Pro GRP对小细胞肺癌的敏感性为79.74%,显著高于CEA、CYFRA21-1和NSE检测,差异均有统计学意义(P<0.05),而联合以上四项指标进行检测的敏感性高达89.24%。且鳞状细胞癌、腺癌及其他疾病的Pro GRP、NSE敏感性明显低于小细胞肺癌,差异均有统计学意义(P<0.01)。结论:血清Pro GRP检测可作为SCLC诊断、疗效评估、预后判断的敏感和特异性指标,Pro GRP、CEA、CYFRA21-1和NSE的联合检测大大提高了小细胞肺癌的诊断率,为临床治疗方案的制定和改进提供了有力的依据。

Objective： To investigate the clinical value of serum gastrin-releasing peptide precursor（ProGRP） in the diagnosis, condition monitoring, curative effect evaluation and prognostic judgement of small cell lung cancer（SCLC）.Method： 86 cases of small cell lung cancer patients admitted to our hospital from July 2012 to August 2014 were selected as the objects, 75 cases of non-small cell lung cancer patients and 45 patients with other benign lung diseases were selected as control.The levels of NSE, CEA, ProGRP and CYFRA21-1 in the serum of patients with lung cancer or other lung diseases were detected by the electrochemical luminescence method before and after treatment, patients with lung cancer recieved imaging examination as well.Result： The sensitivity of ProGRP was 79.74% to the diagnosis of small cell lung cancer（SCLC）, higher than the sensitivity of CEA, NES and CYFRA21-1, the differences were statistically significant（P〈0.05）.The joint detection of the above indicators on SCLC could reach 89.24%.The sensitivity of ProGRP, NES to the diagnosis of squamous cell carcinoma, adenocarcinoma and other diseases was lower than their sensitivity to the diagnosis of SCLC, the differences were statistically significant（p〈0.01）. Conclusion： The serum ProGRP detection can he sensitive and specific indicators in the diagnosis, disease treatment, condition monitoring, curative effect evaluation and prognostic judgement of SCLC, the ProGRP, NSE, CEA and CYFRA21-1 joint detection can greatly improve the accuracy rate of diagnosis of small cell lung cancer, providing powerful basis for the decisian and improvement of therapeutic schedule.