血清标志物pro-GRP、NSE在小细胞肺癌鉴别诊断中的价值

摘要

目的：探讨血清标志物胃泌素释放肽前体（pro‐GRP）、神经元特异性烯醇化酶（NSE）对小细胞肺癌（SCLC）鉴别诊断的价值。方法选择SCLC患者120例（SCLC组）、非小细胞肺癌（NSCLC ）患者130例、良性肺部疾病者80例，以及同期健康体检者90例（健康对照组），检测血清pro‐GRP、NSE水平，SPSS13．0进行统计分析，分析各标志物的血清水平和阳性率。Graph‐Pad Prism 5进行ROC曲线绘制。结果 SCLC组患者血pro‐GRP、NSE水平明显高于NSCLC组、良性肺部疾病组和健康对照组，差异有统计学意义（P＜0．05）。SCLC组患者血清pro‐GRP阳性率（80．00％）高于其他3组，差异有统计学意义（P＜0．05）。SCLC组和NSCLC组NSE阳性率比较差异无统计学意义（P＞0．05）。pro‐GRP、NSE单独及联合诊断SCLC的ROC曲线下面积分别为0．890、0．810和0．915。结论 NSE只能鉴定良恶性肺部疾病，不能鉴定SCLC和NSCLC ；pro‐GRP既可鉴定良恶性肺部疾病，还可鉴定肺癌的SCLC和NSCLC病理分型；pro‐GRP、NSE联合检测对SCLC的鉴别诊断有重要价值。%Objective To evaluate the values of gastrin‐releasing peptide (pro‐GRP) and neuronspecific enolase (NSE) in differ‐ential diagnosing of small cell lung cancer (SCLC) .Methods Serum samples from 120 SCLC patients ,130 non‐small cell lung canc‐er (NSCLC) ,80 Patients with benign lung disease and 90 healthy donors were collected to detect the level of pro‐GRP and NSE .All data were analyzed by SPSS13 .0 and then we analyzed the serum level and positive rates of the two tumor markers .ROC was gener‐ated by GraphPad Prism 5 .Results The expression level of pro‐GRP and NSE in SCLC group were significant higher than NSCLC group、benign lung disease group and healthy donors group (P<0 .05) .The positive rates of pro‐GRP in SCLC were higher than the other three groups (P<0 .05) .However ,there had no significant difference between SCLC group and NSCLC group in the posi‐tive rates of NSE(P>0 .05) .ROC area under curve of pro‐GRP ,NSE and both were 0 .890 ,0 .810 and 0 .915 ,separately .Conclusion The tumor biomarker of NSE could only identify of benign and malignant lung diseases ,but can not identify the type of lung canc‐er including SCLC and NSCLC ;Nonetheless the tumor biomarker of pro‐GRP could not only identify benign and malignant lung dis‐eases ,but also identify the pathological type of SCLC and NSCLC ;Combined determination of pro‐GRP and NSE had significant values for the differential diagnosis of SCLC .