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目的探讨胃泌素释放肽前体(Pro-GRP)作为小细胞肺癌(SCLC)新标记物的临床意义,并与神经元特异性烯醇酶(NSE)进行比较。方法用雅培化学发光分析仪I2000(美国产)测试血清中Pro-GRP水平,比较86例SCLC初治患者血清中Pro-GRP与NSE水平,分析Pro-GRP诊断SCLC的灵敏度、特异度。分析化疗前后患者血清NSE和Pro-GRP水平与生存率的关系及相关性,采用ROC曲线确定阈值,比较诊断准确性。结果血清Pro-GRP诊断SCLC的敏感性和特异性分别为88.37%和93.82%。化疗后,Pro-GRP和NSE水平均下降。在复发/进展的患者中,Pro-GRP的阳性率显著高于NSE(P<0.05)。Pro-GRP和NSE在SCLC诊断中的分布有明显的相关性(r=0.256,P<0.01)。结论 Pro-GRP是较NSE更为特异、敏感的SCLC肿瘤标志物,还可以反映疗效,监测复发。
Objective To investigate the clinical significance of Pro-GRP as a new marker of small cell lung cancer (SCLC) and to compare with neuron-specific enolase (NSE). Methods Serum levels of Pro-GRP were measured by Abbott chemiluminescence analyzer I2000 (USA). The serum levels of Pro-GRP and NSE in 86 patients with primary SCLC were compared. The sensitivity and specificity of Pro-GRP in diagnosing SCLC were analyzed. The relationship between serum NSE and Pro-GRP levels and survival rate before and after chemotherapy was analyzed. The ROC curve was used to determine the threshold and the diagnostic accuracy was compared. Results The sensitivity and specificity of serum Pro-GRP in the diagnosis of SCLC were 88.37% and 93.82% respectively. After chemotherapy, Pro-GRP and NSE levels decreased. In patients with recurrent / advanced disease, the positive rate of Pro-GRP was significantly higher than that of NSE (P <0.05). The distribution of Pro-GRP and NSE in SCLC was significantly correlated (r = 0.256, P <0.01). Conclusion Pro-GRP is a more specific and sensitive SCLC tumor marker than NSE. It can also reflect the curative effect and monitor recurrence.