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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

25卷

期数:

2019年03期

页码:

234-240

栏目:

临床医学

出版日期:

2019-05-20

文章信息/Info

Title:

Diagnosis value of pro-gastrin-releasing peptide precursor for small cell lung cancer

文章编号:

1006-8147(2019)03-0234-07

作者:

董傲然; 张家丽; 任秀宝; 张新伟

（天津医科大学肿瘤医院生物治疗科，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心，天津市肿瘤免疫与生物治疗重点实验室，天津 300060）

Author(s):

DONG Ao-ran;  ZHANG Jia-li;  REN Xiu-bao;  ZHANG Xin-wei

（Ｄｅｐａｒｔｍｅｎｔ ｏｆ Biotherapy, Cancer Institute and Hospital, Tianjin Medical University; National clinical Research Center for Cancer; Key laboratory of Cancer Prevention and Therapy; Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Cancer Immunology and Biotherapy, Tianjin 300060, China）

关键词:

小细胞肺癌; 促胃泌素释放肽前体; TNM分期; 诊断

Keywords:

small cell lung cancer;  ProGRP;  TNM staging;  diagnosis

分类号:

R730.4

DOI:

-

文献标志码:

A

摘要:

目的：探讨促胃泌素释放肽前体（ProGRPp）对小细胞肺癌（SCLC）的诊断价值。方法：检测4 251名初治原发肺癌患者外周血ProGRPp、神经元特异性烯醇酶（NSE）、鳞状细胞癌抗原(SCC)、细胞角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、糖类抗原199（CA-199）水平，运用受试者工作曲线（ROC）对检测结果进行临床评价。结果：ProGRPp和NSE诊断SCLC灵敏度分别为86.1%、80.2%，特异度分别为96.6%、84.8%。并且在Ⅰ~Ⅱ、Ⅲ、Ⅳ期肺癌中ProGRPp诊断SCLC的临界值分别为56、72、99 ng/L，灵敏度分别为95.7%、84.6%、85.7%，特异度分别为93.0%、97.1%、98.5%。在Ⅰ~Ⅱ期肺癌患者中联合ProGRPp与CYFRA21-1/ProGRPp、CYFRA21-1/NSE未进一步提高灵敏度、特异度，而在Ⅲ、Ⅳ期，联合CYFRA21-1/NSE诊断SCLC灵敏度分别提高到93.8%、97.0%，在Ⅳ期联合CYFRA21-1/ProGRPp诊断SCLC特异度提高到99.0%。结论：ProGRPp诊断SCLC具有较高的灵敏度及特异度，建议不同分期采用不同的临界值，另外联合CYFRA21-1/ProGRPp、CYFRA21-1/NSE能进一步增强对肺癌病理类型鉴别的作用。

Abstract:

Objective: To investigate the values of progastrin-releasing peptide precursor (ProGRPp) in the diagnosis of small cell lung cancer (SCLC). Methods: In this study, ProGRPp, and neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC), cytokeratin 19 (CYFRA21-1), carcinoembryonic antigen (CEA), and cancer antigen 199 (CA-199) were detected in peripheral blood of 4 251patients who were diagnosed with primary lung cancer, and ROC curve was used to analyze the results. Results: The sensitivities of ProGRPp and NSE in the diagnosis of SCLC were 86.1% and 80.2%, and the specificities were 96.6% and 84.8%, respectively. In lung carcinoma , the cut-off values of ProGRPp in the diagnosis of SCLC in stage I~II, III, and IV were 56, 72, 99 ng /L, the sensitivities were 95.7%, 84.6%, and 85.7% respectively, and the specificities were 93.0%, 97.1%and 98.5%, respectively. Combination of ProGRPp with CYFRA21-1/ ProGRPp, CYFRA21-1/NSE did not further increase sensitivity or specificity of diagnosis of SCLC in patients with stage I~II lung cancer, but with the combination of CYFRA21-1/NSE and ProGRPp in stages III and IV, the sensitivities of diagnosis of SCLC increased to 93.8% and 97.0% respecitively, and the specificity increased to 99.0% with the combination of CYFRA21-1/ ProGRPp and ProGRPp in the diagnosis of SCLC among stage IV lung cancer patients. Conclusion: ProGRPp shows significant higher sensitivity and specificity in the diagnosis of SCLC. Different cut-off values are recommended in different stages. In addition, the combination of CYFRA21-1/ ProGRPp、CYFRA21-1/ NSE could further improve the diagnosis of lung cancer pathological types.

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备注/Memo

备注/Memo:

基金项目 国家科技支撑计划资助项目（2015BAI12B12）
作者简介 董傲然（1993-），女，硕士在读，研究方向：生物免疫治疗；通信作者：张新伟，E-mail：zhangxinwei@tjmuch.com。

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更新日期/Last Update: 2019-07-03