血清神经元特异性烯醇化酶/癌胚抗原及胃泌素释放肽前体/癌胚抗原比值在诊断小细胞肺癌中的价值
|
摘要
目的:观察肺癌患者血清中神经元特异性烯醇化酶(neuron-specificenolase,NSE)、癌胚抗原(carcinoembryonicantigen,CEA)、胃泌素释放肽前体(pro-gastrinreleasingpeptide,pro-GRP)的含量,分析NSE/CEA和pro-GRP/CEA在鉴别诊断小细胞肺癌(small cell lung cancer,SCLC)中的应用价值。方法:应用电化学发光法分别检测60例非小细胞肺癌(non-small cell lung cancer,NSCLC;肺鳞癌22例、肺腺癌38例)及45例SCLC患者血清中的NSE,pro-GRP,CEA的含量,并计算NSE/CE A和pro-GRP/CE A。利用ROC曲线确定NSE/CE A和pro-GRP/CE A鉴别诊断SCLC的最佳界值。结果:NSE/CEA值在鉴别SCLC和NSCLC的ROC曲线下面积为0.90,敏感度为88.90%,特异度85.00%,最佳判断值为3.78。pro-GRP/CE A值在鉴别SCLC和其他两种肺癌的ROC曲线下面积为0.94,敏感度为86.70%、特异度91.70%,最佳判断值为28.61。结论:NSE/CEA和pro-GRP/CEA有助于鉴别诊断SCLC和NSCLC,有较高的应用价值。
Objective: To evaluate the levels of neuron-specific enolase(NSE), carcinoembryonic antigen(CEA)and pro-gastrin releasing peptide(pro-GRP) in the serum of patients with lung cancer and analyze clinical significance of NSE/CEA and pro-GRP/CEA ratio in the differential diagnosis of small cell lung cancer(SCLC).Methods: Forty-five cases with SCLC and 60 patients with non-small cell lung cancer lung cancer(NSCLC),including 22 cases with lung squamous carcinoma and 38 cases with lung adenocarcinoma were selected.The levels of multiple serum tumor markers(NSE, CEA, pro-GRP) in the serum of patients were detected by electrochemiluminescence immunoassay. And the ratio of NSE/CEA, pro-GRP/CEA were calculated. ROC curve was used to evaluate the best value of NSE/CEA and pro-GRP/CEA ratio in the differential diagnosis of SCLC.Results: At the threshold of 3.78, sensitivity and specificity of NSE/CEA as a serologic marker were 88.90% and85.00%, respectively for distinguish SCLC and NSCLC. ROC curve showed that area under the curve(AUC) was0.90. At the threshold of 28.61, sensitivity and specificity of pro-GRP/CEA as a serologic marker were 86.70% and91.70%, respectively for distinguish SCLC and NSCLC. ROC curve showed that AUC was 0.94. Conclusion:Combined examination of multiple serum tumor markers and the NSE/CEA and pro-GRP/CEA ratio can effectively improve the accuracy in the differential diagnosis of SCLC.
Objective: To evaluate the levels of neuron-specific enolase(NSE), carcinoembryonic antigen(CEA)and pro-gastrin releasing peptide(pro-GRP) in the serum of patients with lung cancer and analyze clinical significance of NSE/CEA and pro-GRP/CEA ratio in the differential diagnosis of small cell lung cancer(SCLC).Methods: Forty-five cases with SCLC and 60 patients with non-small cell lung cancer lung cancer(NSCLC),including 22 cases with lung squamous carcinoma and 38 cases with lung adenocarcinoma were selected.The levels of multiple serum tumor markers(NSE, CEA, pro-GRP) in the serum of patients were detected by electrochemiluminescence immunoassay. And the ratio of NSE/CEA, pro-GRP/CEA were calculated. ROC curve was used to evaluate the best value of NSE/CEA and pro-GRP/CEA ratio in the differential diagnosis of SCLC.Results: At the threshold of 3.78, sensitivity and specificity of NSE/CEA as a serologic marker were 88.90% and85.00%, respectively for distinguish SCLC and NSCLC. ROC curve showed that area under the curve(AUC) was0.90. At the threshold of 28.61, sensitivity and specificity of pro-GRP/CEA as a serologic marker were 86.70% and91.70%, respectively for distinguish SCLC and NSCLC. ROC curve showed that AUC was 0.94. Conclusion:Combined examination of multiple serum tumor markers and the NSE/CEA and pro-GRP/CEA ratio can effectively improve the accuracy in the differential diagnosis of SCLC.
引文
1.梁平,李峻岭.晚期肺鳞癌患者肿瘤标志物测定的临床分析[J].中国肺癌杂志,2016,19(10):641-647.LIANG Ping,LI Junling.Clinical significance of tumor marker detection in patients with advanced squamous cell carcinoma of the lung[J].Chinese Journal of Lung Cancer,2016,19(10):641-647.
2.Blandin Knight S,Crosbie PA,Balata H,et al.Progress and prospects of early detection in lung cancer[J].Open Biol,2017,7(9):170070.
3.Liu LJ,Teng JL,Zhang LJ,et al.The combination of the tumor markers suggests the histological diagnosis of lung cancer[J].Biomed Res Int,2017,2017:2013989.
4.孔梓任,王裕,马文斌,等.癌症筛查在中国的开展前景[J].中国医药导报,2018,15(9):167-171.KONG Ziren,WANG Yu,MA Wenbin,et al.Prospects of cancer screening in China[J].China Medical Herald,2018,15(9):167-171.
5.王彬阶,胡丽,崔天盆,等.不同来源标本细胞病理学联合检查在肺癌诊断中的价值[J].检验医学,2016,31(1):13-16.WANG Binjie,HU Li,CUI Tianpen,et al.Significance on different sample sources of cytopathological combined determination in the diagnosis of lung cancer[J].Laboratory Medicine,2016,31(1):13-16.
6.Wang L,Wang D,Zheng G,et al.Clinical evaluation and therapeutic monitoring value of serum tumor markers in lung cancer[J].Int J Biol Markers,2016,31(1):e80-e87.
7.黄芳,薛丽,宋琳岚,等.胸水和血清CEA、CA125、CYFRA21-1、NSE和Pro-GRP联合检测对肺癌的诊断价值[J].现代肿瘤医学,2018,26(13):2054-2058.HUANG Fang,XUE Li,SONG Linlan,et al.Diagnostic value of combined detection of CEA,CA125,CYFRA21-1,NSE and ProGRP in lung cancer pleural effusion and serum[J].Journal of Modern Oncology,2018,26(13):2054-2058.
8.彭彦,王燕,李峻岭,等.血清NSE、ProGRP和LDH在小细胞肺癌诊断治疗中的作用[J].中国肺癌杂志,2016,19(9):590-594.PENG Yan,WANG Yan,LI Junling,et al.Utility of NSE,ProGRPand LDH in diagnosis and treatment in patients with small cell lung cancer[J].Chinese Journal of Lung Cancer,2016,19(9):590-594.
9.Wojcik E,Kulpa JK.Pro-gastrin-releasing peptide(ProGRP)as a biomarker in small-cell lung cancer diagnosis,monitoring and evaluation of treatment response[J].Lung Cancer(Auckl),2017,8:231-240.
10.戎荣,程义壮,沈佐君.四种血清肿瘤标志物联合检测在肺癌诊断中的价值[J].山东医药,2018,58(1):78-80.RONG Rong,CHENG Yizhuang,SHEN Zuojun.Value of combined detection of four serum tumor markers in the diagnosis of lung cancer[J].Shandong Medical Journal,2018,58(1):78-80.
11.邹莉玲,余小金,闵捷,等.ROC曲线在医学诊断中的应用与进展[J].东南大学学报(医学版),2003,22(1):67-70.ZOU Liling,YU Xiaojin,MIN Jie,et al.Application and development of ROC curve approach for medical diagnostic tests[J].Journal of Southeast University.Medical Science Edition,2003,22(1):67-70.
2.Blandin Knight S,Crosbie PA,Balata H,et al.Progress and prospects of early detection in lung cancer[J].Open Biol,2017,7(9):170070.
3.Liu LJ,Teng JL,Zhang LJ,et al.The combination of the tumor markers suggests the histological diagnosis of lung cancer[J].Biomed Res Int,2017,2017:2013989.
4.孔梓任,王裕,马文斌,等.癌症筛查在中国的开展前景[J].中国医药导报,2018,15(9):167-171.KONG Ziren,WANG Yu,MA Wenbin,et al.Prospects of cancer screening in China[J].China Medical Herald,2018,15(9):167-171.
5.王彬阶,胡丽,崔天盆,等.不同来源标本细胞病理学联合检查在肺癌诊断中的价值[J].检验医学,2016,31(1):13-16.WANG Binjie,HU Li,CUI Tianpen,et al.Significance on different sample sources of cytopathological combined determination in the diagnosis of lung cancer[J].Laboratory Medicine,2016,31(1):13-16.
6.Wang L,Wang D,Zheng G,et al.Clinical evaluation and therapeutic monitoring value of serum tumor markers in lung cancer[J].Int J Biol Markers,2016,31(1):e80-e87.
7.黄芳,薛丽,宋琳岚,等.胸水和血清CEA、CA125、CYFRA21-1、NSE和Pro-GRP联合检测对肺癌的诊断价值[J].现代肿瘤医学,2018,26(13):2054-2058.HUANG Fang,XUE Li,SONG Linlan,et al.Diagnostic value of combined detection of CEA,CA125,CYFRA21-1,NSE and ProGRP in lung cancer pleural effusion and serum[J].Journal of Modern Oncology,2018,26(13):2054-2058.
8.彭彦,王燕,李峻岭,等.血清NSE、ProGRP和LDH在小细胞肺癌诊断治疗中的作用[J].中国肺癌杂志,2016,19(9):590-594.PENG Yan,WANG Yan,LI Junling,et al.Utility of NSE,ProGRPand LDH in diagnosis and treatment in patients with small cell lung cancer[J].Chinese Journal of Lung Cancer,2016,19(9):590-594.
9.Wojcik E,Kulpa JK.Pro-gastrin-releasing peptide(ProGRP)as a biomarker in small-cell lung cancer diagnosis,monitoring and evaluation of treatment response[J].Lung Cancer(Auckl),2017,8:231-240.
10.戎荣,程义壮,沈佐君.四种血清肿瘤标志物联合检测在肺癌诊断中的价值[J].山东医药,2018,58(1):78-80.RONG Rong,CHENG Yizhuang,SHEN Zuojun.Value of combined detection of four serum tumor markers in the diagnosis of lung cancer[J].Shandong Medical Journal,2018,58(1):78-80.
11.邹莉玲,余小金,闵捷,等.ROC曲线在医学诊断中的应用与进展[J].东南大学学报(医学版),2003,22(1):67-70.ZOU Liling,YU Xiaojin,MIN Jie,et al.Application and development of ROC curve approach for medical diagnostic tests[J].Journal of Southeast University.Medical Science Edition,2003,22(1):67-70.