血清胃泌素释放肽前体和神经元烯醇化酶在小细胞肺癌早期诊断中的价值及其相关性

目的探讨胃泌素释放肽前体(progastrinreleasingpeptide,ProGRP)和神经元烯醇化酶(neuronspecificenolase,NSE)在小细胞肺癌(smallcelllungcancer,SCLC)早期诊断中的作用及两种标志物之间的相关性。方法分别应用双抗体夹心ELISA法和电化学发光免疫法测定了63例SCLC、41例良性肺疾病及40例非小细胞肺癌(nonsmallcelllungcancer,NSCLC)患者血清中ProGRP和NSE的水平。结果单个检测ProGRP、NSE及联合检测ProGRP和NSE(ProGRP+NSE)诊断SCLC的特异性分别为88.89%、80.25%及66.67%,敏感性分别为73.02%、63.49%及84.13%;NSCLC中ProGRP和NSE的敏感性分别为12.5%和22.50%;ProGRP+NSE诊断SCLC的敏感性明显高于NSE(P<0.01),但和ProGRP相比,两者差异无显著性(P>0.05);NSE诊断早期SCLC的敏感性仅36.84%,ProGRP及ProGRP+NSE诊断早期SCLC的敏感性分别为63.16%和73.68%,和晚期SCLC(分别为77.27%及88.64%)相比,均无显著性差异(P>0.05);在SCLC中,ProGRP和NSE的相关性较强(χ2=5.00,P<0.05)。结论NSE对SCLC早期诊断价值有限;ProGRP及ProGRP+NSE可能是肺癌分型及SCLC诊断,尤其是早期诊断的较好指标。

Significance and correlation between serum proGRP and NSE in the early diagnosis of small cell lung cancer

Objective To investigate the significance and correlation between serum ProGRP and NSE in the early diagnosis of small cell lung cancer (SCLC). Methods Serum ProGRP and NSE were detected in 63 patients with SCLC, 40 patients with non-small cell lung cancer (NSCLC) and 41 patients with benign lung disease, using sandwich enzyme immunoassay and electrochemiluminescence immunoassay respectively. Results ① The specificity of individual ProGRP and NSE and the combined detection of ProGRP and NSE for the diagnosis of SCLC were 88.89%, 80.25% and 66.67% respectively, and the sensitivity were 73.02%, 63.49% and 84.13%, respectively. ② The sensitivity of ProGRP and NSE for the diagnosis of NSCLC were 12.5% and 22.50%, respectively. ③ In SCLCs, the sensitivity of combined detection of ProGRP and NSE was significantly higher than that of NSE alone (P<0.05), whereas the sensitivity of ProGRP alone and the combination of ProGRP and NSE had no statistical difference (P>0.05). ④ The sensitivity of each of ProGRP and the combination of ProGRP and NSE in early stage SCLC was insignificantly lower than that in late stage SCLC (P>0.05). ⑤ There was a relatively strong correlation between ProGRP and NSE ( χ2 = 5.00 , P< 0.05 ). Conclusion ProGRP alone and the combined measurement of ProGRP and NSE could be better markers for histopathological type of lung cancer and early diagnosis of SCLCs.