血清 ProGRP，NSE 和 CEA 检测对小细胞肺癌的诊断价值

摘要

目的：探讨血清胃泌素释放肽前体（ProGRP）、神经元特异性烯醇化酶（NSE）和癌胚抗原（CEA）联合检测对小细胞肺癌（SCLC）的诊断价值。方法471例肺部肿瘤患者均来自呼吸内科和胸外科住院患者，另从健康查体中心随机选取162例健康人作为对照组。所有研究对象均空腹采血，采用电化学发光法检测其血清 ProGRP，NSE 和 CEA 水平，绘制ROC 曲线并计算曲线下面积（the area under the curve，AUC）。结果SCLC 患者血清 ProGRP 和 NSE 水平显著高于非小细胞肺癌组、肺良性病变组和正常对照组（P ＜0.01）。SCLC 患者血清 CEA 水平显著高于肺良性病变组和正常对照组（P＜0.05）。ProGRP，NSE 和 CEA 诊断 SCLC 的 AUC 分别为0.933，0.777和0.554。ProGRP，NSE 和 CEA 诊断 SCLC 的敏感度分别为82.6％，60.4％和41.6％，特异度分别为95.2％，83.3％和71.7％。联合检测 ProGRP，NSE 和 CEA 诊断SCLC 的敏感度为91.3％，特异度为65.3％。结论血清 ProGRP 检测对 SCLC 具有较高的诊断价值；ProGRP，NSE 和CEA 的联合检测有助于 SCLC 的早期诊断。%Objective To investigate the diagnostic value of combined detection of serum gastrin-releasing peptide precursor (ProGRP),neuron specific enolization enzyme(NSE)and carcinoembryonicantigen(CEA)in small cell lung cancer(SCLC). Methods 471 patients with lung tumor from department of respiratory medicine and thoracic surgery and 162 healthy people from medical examination center were studied.Serum levels of ProGRP,NSE and CEA were detected by using electrochemi-cal luminescence method.ROC curves were drawn and the area under the curve (AUC)was calculated.Results The levels of ProGRP and NSE were significantly higher in patients with SCLC than those in NSCLC,lung benign disease group and normal control group (P <0.01).The levels of CEA were significantly higher in SCLC than those in patients with lung be-nign disease group and normal control group (P <0.05).The AUC of ProGRP,NSE and CEA in the diagnosis of SCLC were 0.933,0.777 and 0.554,respectively.The sensitivity of ProGRP,NSE and CEA in the diagnosis of SCLC were 82.6%,60.4%,41.6% and the specificity were 95.2%,83.3% and 71.7% respectively.The sensitivity of combined detec-tion of ProGRP,NSE and CEA was 91.3% and the specificity was 65.3%.Conclusion The serum ProGRP detection has a higher diagnostic value for SCLC.The combined detection of ProGRP,NSE and CEA is useful in the early diagnosis of SCLC.