非小细胞肺癌患者血清ProGRP、NSE、CEA水平变化及其与化疗心脏毒性及预后的关系

Changes of serum ProGRP,NSE and CEA levels in patients with non-small cell lung cancer and their relationship with chemotherapy cardiotoxicity and prognosis

目的分析非小细胞肺癌(NSCLC)患者血清胃泌素释放肽前体(ProGRP)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)水平变化及其与化疗心脏毒性及预后的关系。方法选择该院2017年1月至2018年1月收治的89例NSCLC患者作为观察组,同期80例肺部炎性病变患者作为对照组。比较观察组与对照组血清ProGRP、NSE、CEA水平;比较化疗过程中出现与未出现心脏毒性的NSCLC患者血清ProGRP、NSE、CEA水平;对观察组患者随访36个月,比较存活患者与死亡患者血清ProGRP、NSE、CEA水平;分析血清ProGRP、NSE、CEA高表达与低表达NSCLC患者的生存情况;分析血清ProGRP、NSE、CEA检测对NSCLC化疗患者心脏毒性的预测价值。结果观察组血清ProGRP、NSE、CEA水平明显高于对照组,差异有统计学意义(P<0.05)。出现心脏毒性的患者血清ProGRP、NSE、CEA水平明显高于未出现心脏毒性的患者,差异有统计学意义(P<0.05)。死亡患者血清ProGRP、NSE、CEA水平明显高于存活患者,差异有统计学意义(P<0.05)。Kaplan-Meier生存分析结果显示,血清ProGRP低表达患者生存率明显高于高表达患者(P<0.05);血清NSE低表达患者生存率明显高于高表达患者(P<0.05);血清CEA低表达患者生存率明显高于高表达患者(P<0.05)。受试者工作特征曲线分析结果显示,血清ProGRP、NSE、CEA预测NSCLC化疗患者心脏毒性的曲线下面积均高于0.900。结论NSCLC患者血清ProGRP、NSE、CEA水平升高与患者预后不良及化疗过程中出现的心脏毒性有关,检测其水平可对患者进行预后评估,并可用于预测患者心脏毒性的发生情况。

Objective To analyze the changes of serum progastrin-releasing peptide(ProGRP),neuron-specific enolase(NSE)and carcinoembryonic antigen(CEA)levels in patients with non-small cell lung cancer(NSCLC)and their relationship with chemotherapy cardiotoxicity and prognosis.Methods A total of 89 patients with NSCLC admitted to the hospital from January 2017 to January 2018 were selected as the observation group,and 80 patients with lung inflammatory lesions in the same period were selected as the control group.The serum levels of ProGRP,NSE and CEA were compared between the observation group and the control group.The serum levels of ProGRP,NSE and CEA were compared between NSCLC patients with and without cardiotoxicity during chemotherapy.The observation group was followed up for 36 months,and the serum levels of ProGRP,NSE and CEA were compared between the survival patients and the dead patients.The survival situation of NSCLC patients with high and low levels of ProGRP,NSE and CEA were analyzed.The predictive value of serum ProGRP,NSE and CEA for cardiotoxicity in NSCLC patients undergoing chemotherapy were analyzed.Results The serum levels of ProGRP,NSE and CEA in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The serum levels of ProGRP,NSE and CEA in patients with cardiotoxicity were significantly higher than those in patients without cardiotoxicity,and the differences were statistically significant(P<0.05).The serum levels of ProGRP,NSE and CEA in the dead patients were significantly higher than those in the survival patients,and the differences were statistically significant(P<0.05).Kaplan-Meier survival analysis showed that the survival rate of patients with low serum ProGRP expression was significantly higher than that of patients with high serum ProGRP expression(P<0.05).The survival rate of patients with low serum NSE expression was significantly higher than that of patients with high serum NSE expression(P<0.05).The survival rate of patients with low CEA expression was significantly higher than that of patients with high CEA expression(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve of serum ProGRP,NSE and CEA in predicting cardiotoxicity in NSCLC patients undergoing chemotherapy were higher than 0.900.Conclusion Elevated levels of ProGRP,NSE and CEA in NSCLC patients are associated with poor prognosis and chemotherapy cardiotoxicity.Detection of its level can be used to evaluate the prognosis of patients and predict the occurrence of cardiotoxicity in patients.