血清ProGRP、NSE水平与小细胞肺癌化疗疗效及预后的相关性研究

Correlation study of serum ProGRP, NSE levels with chemotherapy efficacy and prognosis in patients with small cell lung cancer

目的探讨小细胞肺癌(SCLC)患者血清胃泌素前体释放钛(ProGRP)和神经元特异性烯醇化酶(NSE)水平与其化疗疗效及预后的相关性研究。方法选择2016年2月~2017年2月于成都市第五人民医院肿瘤科及呼吸内科就诊的符合诊断标准的SCLC患者103例为研究对象,给予2个周期及以上的标准化疗方案。采用酶联免疫吸附试验(ELISA)检测血清中ProGRP水平,采用电化学发光法(ECLIA)检测血清NSE水平。以中位血清ProGRP和NSE为界将研究对象分为ProGRP高水平组和ProGRP低水平组,NSE高水平组和NSE低水平组。分析两指标与疗效及预后的关系。结果肿瘤直径≥4 cm、临床分期为广泛期、远处转移、有吸烟史的SCLC患者血清ProGRP和NSE水平高于肿瘤直径<4 cm、临床分期为局限期、无远处转移、无吸烟史的SCLC患者(P < 0.05)。ProGRP低水平组化疗效果优于ProGRP高水平组,NSE低水平组PFS高于NSE高水平组。影响SCLC患者预后的因素有临床分期(OR = 4.986,95%CI:3.774~9.876,P = 0.003)、远处转移(OR = 3.659,95%CI:2.182~7.569,P = 0.016)及血清NSE(OR = 2.879,95%CI:1.487~6.721,P = 0.005)。结论血清ProGRP可预测SCLC患者的临床疗效,血清NSE可预测SCLC患者的预后,临床治疗中应综合评估两个指标,同时密切关注有远处转移或临床分期为广泛期的SCLC患者。

Objective To investigate the relationship of serum levels of pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) with chemotherapy efficacy and prognosis in patients with small cell lung cancer (SCLC). Methods A total of 103 SCLC patients who met the diagnostic criteria diagnosed in Oncology and Respiratory Department of Chengdu Fifth People′s Hospital from February 2016 to February 2017 were selected as study objects. Two cycles or more of the standard chemotherapy regimens were given to them. Serum ProGRP level was measured by enzyme-linked immunosorbent assay (ELISA), and serum NSE level was measured by electrochemiluminescence immunoassay (ECLIA). Taking the median serum ProGRP and NSE level as the boundary, the objects were divided into high ProGRP level group and low ProGRP level group, high NSE level group and low NSE level group, the relationship of the two indexes with efficacy and prognosis was analyzed. Results The serum levels of ProGRP and NSE in SCLC patients with tumor diameter ≥4 cm, extensive metastasis, distant metastasis and smoking history were higher than those in SCLC patients with tumor diameter <4 cm, limited clinical stage, no distant metastasis and no smoking history (P < 0.05). The chemotherapeutic efficacy of low ProGRP level group was higher than that of high ProGRP level group, and PFS of low NSE level group was higher than that of high NSE level group. The factors affecting the prognosis of SCLC patients were clinical stage (OR = 4.986, 95%CI: 3.774-9.876, P = 0.003), distant metastasis (OR = 3.659, 95%CI: 2.182-7.569, P = 0.016) and serum NSE (OR = 2.879, 95%CI: 1.487-6.721, P = 0.005). Conclusion Serum ProGRP can predict the clinical efficacy of SCLC patients, serum NSE can predict the prognosis of SCLC patients. Two indicators should be evaluated comprehensively in clinical treatment, and close attention should be paid to SCLC patients with distant metastasis or extensive clinical stage.