血清Pro-GRP、NSE在非小细胞肺癌化疗前后的水平变化及临床意义

Changes in serum Pro-GRP and NSE levels before and after chemotherapy in non-small cell lung cancer and their clinical significance

目的分析血清胃泌素释放肽前体(Pro-GRP)、神经元特异性烯醇化酶(NSE)在非小细胞肺癌(NSCLC)化疗前后的水平变化及临床意义。方法收集2020年2月—2022年2月本院收治的NSCLC患者126例为观察组,另选取同期于本院进行体检的健康体检者108例为对照组。对比观察组与对照组患者Pro-GRP、NSE水平,分析观察组患者化疗前后Pro-GRP、NSE水平变化情况;分析影响NSCLC患者化疗效果的危险因素;分析Pro-GRP、NSE单独及联合检测对NSCLC患者化疗效果的预测价值。结果观察组患者化疗前Pro-GRP、NSE水平均高于对照组,差异有统计学意义(t=11.584,P<0.001;t=4.951,P<0.001),且观察组化疗前Pro-GRP、NSE水平均高于化疗后,差异有统计学意义(t=5.901,P<0.001;t=2.633,P=0.008)。化疗后,有效组共有患者98例,无效组共有患者28例。2组患者吸烟史、慢性病史、远处转移情况、Pro-GRP水平及NSE水平比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示:有吸烟史、有慢性病史、有远处转移、Pro-GRP升高及NSE升高是影响NSCLC患者化疗效果的危险因素(P<0.05)。受试者工作特征(ROC)曲线结果显示,Pro-GRP+NSE预测NSCLC患者化疗效果的曲线下面积(AUC)为0.911,95%CI:0.861~0.962,敏感度为0.871,特异度为0.862。结论NSCLC患者化疗后血清Pro-GRP、NSE水平降低,而通过检测Pro-GRP、NSE水平可对患者化疗效果进行预测,且2个指标联合预测的价值更高。

Objective To analyze the changes in serum levels of pro-gastrin-releasing peptide(Pro-GRP)and neuron-specific enolase(NSE)before and after chemotherapy in non-small cell lung cancer(NSCLC)and their clinical significance.Methods A total of 126 NSCLC patients admitted to our hospital from February 2020 to February 2022 were selected as the observation group,and 108 healthy individuals who underwent physical examinations at our hospital during the same period were selected as controls.The levels of Pro-GRP and NSE in the observation group and the control group were compared,and the changes in Pro-GRP and NSE levels before and after chemotherapy in the observation group were analyzed.The risk factors affecting the efficacy of chemotherapy in NSCLC patients were analyzed.The predictive value of Pro-GRP,NSE,and combined detection for the efficacy of chemotherapy in NSCLC patients was analyzed.Results The levels of Pro-GRP and NSE in the observation group before chemotherapy were significantly higher than those in the control group(t=11.584,P<0.001;t=4.951,P<0.001).The levels of Pro-GRP and NSE in the observation group before chemotherapy were significantly higher than those after chemotherapy(t=5.901,P<0.001;t=2.633,P=0.008).After chemotherapy,there were 98 patients in the effective group and 28 patients in the ineffective group;the differences in smoking history,history of chronic diseases,distant metastasis,Pro-GRP levels,and NSE levels between the two groups were statistically significant(P<0.05).Logistic regression analysis showed that smoking history,history of chronic diseases,distant metastasis,elevated Pro-GRP,and elevated NSE were risk factors for the efficacy of chemotherapy in NSCLC patients(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for the prediction of chemotherapy efficacy in NSCLC patients using Pro-GRP+NSE was 0.911(95%CI:0.861-0.962),with a sensitivity and specificity of 0.871 and 0.862,respectively.Conclusion Serum Pro-GRP and NSE levels decrease after chemotherapy in NSCLC patients,and the levels of Pro-GRP and NSE can be used to predict the efficacy of chemotherapy.The predictive value is higher when both indicators are combined.