神经内分泌标志物ProGRP、 CGA、NSE在肺小细胞癌患者中表达的临床意义及对预后的影响

Prognostic significance of neuroendocrine markers (ProGRP, CGA and NSE) in patients with small-cell lung cancer

目的研究神经内分泌标志物嗜铬粒蛋白A(chromogranin A, CGA)、促胃泌素释放肽(pro-gastrin-releasing peptide,ProGRP)和神经元特异性烯醇化酶(neuron-specific enolase, NSE)表达水平在肺小细胞癌患者中的临床意义及对预后的影响。方法用固相"双位点夹心"免疫放射分析实验方法,前瞻性分析肺小细胞癌(small cell lung cancer, SCLC)神经内分泌标志物循环神经内分泌标志物嗜铬粒蛋白A(CGA)、促胃泌素释放肽(ProGRP)和神经元特异性烯醇化酶(NSE)的分泌,分析其临床病理资料、评估其疾病分期;统计分析各因素对与生存率的相关性。结果单变量分析和单变量Cox回归模型发现存活率与一般健康状态(performance status, PS),疾病分期,CGA,ProGRP和NSE水平之间存在显著统计学相关性,PS≥2(中位生存期MS为12 vs 14月,P=0.001),广泛期疾病(extensive disease ED)(MS为10 vs 15月,P<0.001),血清CGA水平>56ng/mL(MS 10 vs 14月,P<0.001),血清ProGRP水平>58 pg/mL(MS 10 vs 15月,P<0.001),血清NSE水平>19ng/mL(MS 10 vs 15月,P<0.001)的患者生存期较短。结论 ProGRP,NSE和CGA在SCLC患者的分期和预后评估价值中具有潜在的作用。

Objective To study the clinical significance neuroendocrine markers chromogranin A(CGA), pro-gastrin-releasing peptide(GRP) and neuron-specific enolase(NSE) in small cell lung cancer(SCLC) and its impact on prognosis. Methods Through the selection of 40 cases of SCLC, the solid phase "double-site sandwich" immunoradiometric assay was used to forward-looking analyze the circulating neuroendocrine markers chromogranin A(CGA) and gastrin-releasing peptide(SCG), ProGRP and NSE. Their clinical pathological data was analyzed, and their clinical stage was evaluated. The correlation of various factors with survival was statistically analyzed. Results Univariate analysis and univariate Cox regression models found patients’ survival was statistically significant correlated performance status(PS), disease stage, CGA, ProGRP and NSE levels. The patient with PS ≥ 2(median survival(MS) was 12 vs 14 months, P=0.001), extensive disease(MS vs 10 vs 15 months, P<0.001), serum CGA level >56 ng/mL(MS 10 vs 14 months, P<0.001), serum ProGRP level >58 pg/mL(MS 10 vs 15 months, P<0.001), and serum NSE level >19 ng/mL(MS 10 vs 15 months, P<0.001) had a shorter survival time. Conclusion There is a potential role for ProGRP, NSE, and CGA in both staging and evaluating prognosis of SCLC patients.