血清胃泌素释放肽前体在小细胞肺癌诊断和分期中的临床意义
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摘要
目的:探讨血清胃泌素释放肽前体(pro GRP)在小细胞肺癌(SCLC)与非小细胞肺癌(NSCLC)的鉴别诊断和临床分期中的价值。方法:应用化学分析法,检测62例初诊SCLC(局限期25例,广泛期37例)、38例NSCLC患者血清pro GRP水平,并与神经元特异性烯醇化酶(NSE)相对照,观察其敏感度、特异度以及与肿瘤临床分期的关系。结果:单个检测pro GRP、NSE和联合检测pro GRP及NSE(pro GRP+NSE)诊断SCLC的敏感度分别为82.93%、64.15%和71.58%。SCLC中pro GRP+NSE阳性率显著高于NSE阳性率(P<0.01),但与pro GRP阳性率差异无统计学意义(P>0.05)。SCLC组患者血清pro GRP和NSE水平均显著高于NSCLC组(P<0.01)。SCLC广泛期患者血清pro GRP和NSE值均显著高于其局限期患者(P<0.01)。结论:pro GRP作为SCLC的标志物,具有敏感度高的特点,并可反映SCLC的分期。pro GRP和NSE联合检测可提高SCLC诊断的准确率。
Objective: To explore the clinical value of the levels of serum progastrin releasing peptide( pro GRP) in the differential diagnosis and clinical staging of small cell lung cancer( SCLC) and non-small cell lung cancer( NSCLC). Methods: The serum levels of pro GRP in 62 patients with SCLC( including 25 cases of limited stage and 37 cases of extensive stage) and 38 patients with NSCLC were measured by chemiluminescent immunoassay,which was compared with neuron specific enolase( NSE). The sensitivity,specificity and tumor staging in all patients were analyzed. Results: The sensitivities of the single detection of pro GRP,NSE and combination detection of pro GRP and NSE in diagnosing SCLC were 82. 93%,64. 15% and 71. 58%,respectively. The positive rate of the combination detection of pro GRP and NSE in diagnosing SCLC was significantly higher than that of the single detection of NSE,the difference of the positive rate between combination detection pro GRP and NSE and single detection of pro GRP was not statistically significant( P > 0. 05). The serum levels of pro GRP and NSE in patients with SCLC were obviously higher than those in NSCLC patients( P < 0. 01). Among the SCLC patients,the serum levels of pro GRP and NSE in extensive stage patients were significantly higher than those in limited stage patients( P < 0. 01). Conclusions: The Pro GRP is a tumor marker of SCLC,which is high sensitivity and specificity,and can reflect the staging. The combination detection of pro GRP and NSE can improve the accurate rate of SCLC diganosis.
Objective: To explore the clinical value of the levels of serum progastrin releasing peptide( pro GRP) in the differential diagnosis and clinical staging of small cell lung cancer( SCLC) and non-small cell lung cancer( NSCLC). Methods: The serum levels of pro GRP in 62 patients with SCLC( including 25 cases of limited stage and 37 cases of extensive stage) and 38 patients with NSCLC were measured by chemiluminescent immunoassay,which was compared with neuron specific enolase( NSE). The sensitivity,specificity and tumor staging in all patients were analyzed. Results: The sensitivities of the single detection of pro GRP,NSE and combination detection of pro GRP and NSE in diagnosing SCLC were 82. 93%,64. 15% and 71. 58%,respectively. The positive rate of the combination detection of pro GRP and NSE in diagnosing SCLC was significantly higher than that of the single detection of NSE,the difference of the positive rate between combination detection pro GRP and NSE and single detection of pro GRP was not statistically significant( P > 0. 05). The serum levels of pro GRP and NSE in patients with SCLC were obviously higher than those in NSCLC patients( P < 0. 01). Among the SCLC patients,the serum levels of pro GRP and NSE in extensive stage patients were significantly higher than those in limited stage patients( P < 0. 01). Conclusions: The Pro GRP is a tumor marker of SCLC,which is high sensitivity and specificity,and can reflect the staging. The combination detection of pro GRP and NSE can improve the accurate rate of SCLC diganosis.
引文
[1]白晓雪,张艳蓓.肺癌肿瘤标志物检测的研究现状[J].临床肺科杂志,2011,16(2):259.
[2]张荣华,郑加荣,陈佳佳.血清肿瘤标志物联合检测对肺癌的临床意义[J].中国实用医刊,2011,38(7):28.
[3]MCDONALD TJ,NILSSON G,VAGNE M,et al.A gastrin releasing peptide from the porcine non-antral gastric tissue[J].Gut,1978,19(9):767.
[4]YAMAGUCHI K,ABE K,KAMEYA,T,et al.Production and molecular size heterogeneity of immunoreactive gastrin-releasing peptide in fetal and adult lungs and primary lung tumors[J].Cancer Res,1983(43):3932.
[5]MIYAKE Y,KODAMA T,YAMAGUCHI K.Pro-gastrin-releasing peptide(31-98)is a specific tumor marker in patients with small cell lung carcinoma[J].Cancer Res,1994(54):2136.
[6]邵良荣,邵杰,肖丽华,等.联合检测血清四种肿瘤标志物对肺癌的诊断价值[J].中国实用医刊,2011,38(1):22.
[7]SCHNEIDER J,PHILIPP M,SALEWSKI L,et al.Progastrinreleasing peptide(Pro GRP)and neuron specific enolase(NSE)in therapy control of patients with small-cell lung cancer[J].Clin Lab,2003,49(1/2):35.
[8]TANG JH,ZHANG XL,ZHANG ZH,et al.Diagnostic value of tumor marker pro-gastrin-releasing peptide in patients with small cell lung cancer:a systematic review[J].Chin Med J(Engl),2011,124(10):1563.
[9]KIM HR,Oh IJ,SHIN MG,et al.Plasma pro GRP concentration is sensitive and specific for discriminating small cell lung cancer from nonmalignant conditions or non-small cell lung cancer[J].J Korean Med Sci,2011,26(5):625.
[2]张荣华,郑加荣,陈佳佳.血清肿瘤标志物联合检测对肺癌的临床意义[J].中国实用医刊,2011,38(7):28.
[3]MCDONALD TJ,NILSSON G,VAGNE M,et al.A gastrin releasing peptide from the porcine non-antral gastric tissue[J].Gut,1978,19(9):767.
[4]YAMAGUCHI K,ABE K,KAMEYA,T,et al.Production and molecular size heterogeneity of immunoreactive gastrin-releasing peptide in fetal and adult lungs and primary lung tumors[J].Cancer Res,1983(43):3932.
[5]MIYAKE Y,KODAMA T,YAMAGUCHI K.Pro-gastrin-releasing peptide(31-98)is a specific tumor marker in patients with small cell lung carcinoma[J].Cancer Res,1994(54):2136.
[6]邵良荣,邵杰,肖丽华,等.联合检测血清四种肿瘤标志物对肺癌的诊断价值[J].中国实用医刊,2011,38(1):22.
[7]SCHNEIDER J,PHILIPP M,SALEWSKI L,et al.Progastrinreleasing peptide(Pro GRP)and neuron specific enolase(NSE)in therapy control of patients with small-cell lung cancer[J].Clin Lab,2003,49(1/2):35.
[8]TANG JH,ZHANG XL,ZHANG ZH,et al.Diagnostic value of tumor marker pro-gastrin-releasing peptide in patients with small cell lung cancer:a systematic review[J].Chin Med J(Engl),2011,124(10):1563.
[9]KIM HR,Oh IJ,SHIN MG,et al.Plasma pro GRP concentration is sensitive and specific for discriminating small cell lung cancer from nonmalignant conditions or non-small cell lung cancer[J].J Korean Med Sci,2011,26(5):625.