中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
4期
384-387
,共4页
刘运秋%耿贺梅%兰璇%李岸凤%邓曦东
劉運鞦%耿賀梅%蘭璇%李岸鳳%鄧晞東
류운추%경하매%란선%리안봉%산희동
小细胞肺癌%胃泌素前体释放肽片断31-98%神经原烯醇化酶%诊断
小細胞肺癌%胃泌素前體釋放肽片斷31-98%神經原烯醇化酶%診斷
소세포폐암%위비소전체석방태편단31-98%신경원희순화매%진단
Small cell lung cancer%Pro-gastrin-releasing peptide31-98%Neuron specific enolase
目的 探讨血清和支气管肺泡灌洗液胃泌素前体释放肽片断31-98(ProGRP)水平与小细胞肺癌(SCLC)不同TNM分期的关系及其临床意义.方法 将明确痛理组织学分型的96例SCLC患者分为3组:Ⅰ～Ⅱ期SCLC(Ⅰ～Ⅱ期)组30例,Ⅲ期SCLC(Ⅲ期)组31例,Ⅳ期SCLC(Ⅳ期)组35例,并以90例确诊的肺部良性病变患者做为对照组.采用酶联免疫吸附实验对所有患者进行血清和支气管肺泡灌洗液ProGRP检测,同时以神经元特异性烯醇化酶(NSE)做对比研究,比较血清和支气管肺泡灌洗液ProGRP水平与SCLC不同TNM分期的关系.结果 Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期组和对照组血清、支气管肺泡灌洗液ProGRP水平分别为(295.33±118.56)μs/mol与(516.67±208.45)μg/mol、(421.13±196.66)μg/mol与(1170.55±414.65)μg/mol、(758.76±326.19)μg/mol与(1739.12±696.08)μg/mol和(29.68±16.32)μg/mol与(49.23±22.50)μg/mol(P均＜0.01);各组血清、支气管肺泡灌洗液NSE水平分别为(10.36±6.76)mg/mol与(16.66±11.62)mg/mol、(24.19±10.88)mg/mol与(45.47±20.74)mg/mol、(35.76±17.30)mg/mol与(65.18±29.87)mg/mol和(9.70±5.28)mg/mol与(9.70±5.28)mg/mol(P均＜0.01).血清和支气管肺泡灌洗液ProGRP和NSE水平,Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期组明显高于对照组(P均＜0.01).各组血清ProGRP检测阳性率分别为60.00%、70.97%、82.86%、6.67%(P均＜0.01),支气管肺泡灌洗液ProGRP检测阳性率分别为63.33%、74.19%、85.71%、4.44%(P均＜0.01);血清NSE检测阳性率分别为23.33%、67.74%、80.00%、22.22%(P均＜0.01),支气管肺泡灌洗液NSE检测阳性率分别为26.67%、70.97%、82.86%、26.67%(P均＜0.01);Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期组支气管肺泡灌洗液ProGRP和NSE检测阳性率均高于血清检测,且均随其分期级别提升而增高;但Ⅲ期组和Ⅳ期组比较差异无统计学意义(P＞0.05).结论 血清和支气管肺泡灌洗液ProGRP及NSE检测对SCLC的诊断与TNM分期均有较大的临床价值;对不同TNM分期SCLC的诊断,支气管肺泡灌洗液ProGRP和NSE检测优于血清检测;对SCLC的早期诊断血清和支气管肺泡灌洗液ProGRP检测优于NSE.
目的 探討血清和支氣管肺泡灌洗液胃泌素前體釋放肽片斷31-98(ProGRP)水平與小細胞肺癌(SCLC)不同TNM分期的關繫及其臨床意義.方法 將明確痛理組織學分型的96例SCLC患者分為3組:Ⅰ～Ⅱ期SCLC(Ⅰ～Ⅱ期)組30例,Ⅲ期SCLC(Ⅲ期)組31例,Ⅳ期SCLC(Ⅳ期)組35例,併以90例確診的肺部良性病變患者做為對照組.採用酶聯免疫吸附實驗對所有患者進行血清和支氣管肺泡灌洗液ProGRP檢測,同時以神經元特異性烯醇化酶(NSE)做對比研究,比較血清和支氣管肺泡灌洗液ProGRP水平與SCLC不同TNM分期的關繫.結果 Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期組和對照組血清、支氣管肺泡灌洗液ProGRP水平分彆為(295.33±118.56)μs/mol與(516.67±208.45)μg/mol、(421.13±196.66)μg/mol與(1170.55±414.65)μg/mol、(758.76±326.19)μg/mol與(1739.12±696.08)μg/mol和(29.68±16.32)μg/mol與(49.23±22.50)μg/mol(P均＜0.01);各組血清、支氣管肺泡灌洗液NSE水平分彆為(10.36±6.76)mg/mol與(16.66±11.62)mg/mol、(24.19±10.88)mg/mol與(45.47±20.74)mg/mol、(35.76±17.30)mg/mol與(65.18±29.87)mg/mol和(9.70±5.28)mg/mol與(9.70±5.28)mg/mol(P均＜0.01).血清和支氣管肺泡灌洗液ProGRP和NSE水平,Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期組明顯高于對照組(P均＜0.01).各組血清ProGRP檢測暘性率分彆為60.00%、70.97%、82.86%、6.67%(P均＜0.01),支氣管肺泡灌洗液ProGRP檢測暘性率分彆為63.33%、74.19%、85.71%、4.44%(P均＜0.01);血清NSE檢測暘性率分彆為23.33%、67.74%、80.00%、22.22%(P均＜0.01),支氣管肺泡灌洗液NSE檢測暘性率分彆為26.67%、70.97%、82.86%、26.67%(P均＜0.01);Ⅰ～Ⅱ期、Ⅲ期、Ⅳ期組支氣管肺泡灌洗液ProGRP和NSE檢測暘性率均高于血清檢測,且均隨其分期級彆提升而增高;但Ⅲ期組和Ⅳ期組比較差異無統計學意義(P＞0.05).結論 血清和支氣管肺泡灌洗液ProGRP及NSE檢測對SCLC的診斷與TNM分期均有較大的臨床價值;對不同TNM分期SCLC的診斷,支氣管肺泡灌洗液ProGRP和NSE檢測優于血清檢測;對SCLC的早期診斷血清和支氣管肺泡灌洗液ProGRP檢測優于NSE.
목적 탐토혈청화지기관폐포관세액위비소전체석방태편단31-98(ProGRP)수평여소세포폐암(SCLC)불동TNM분기적관계급기림상의의.방법 장명학통리조직학분형적96례SCLC환자분위3조:Ⅰ～Ⅱ기SCLC(Ⅰ～Ⅱ기)조30례,Ⅲ기SCLC(Ⅲ기)조31례,Ⅳ기SCLC(Ⅳ기)조35례,병이90례학진적폐부량성병변환자주위대조조.채용매련면역흡부실험대소유환자진행혈청화지기관폐포관세액ProGRP검측,동시이신경원특이성희순화매(NSE)주대비연구,비교혈청화지기관폐포관세액ProGRP수평여SCLC불동TNM분기적관계.결과 Ⅰ～Ⅱ기、Ⅲ기、Ⅳ기조화대조조혈청、지기관폐포관세액ProGRP수평분별위(295.33±118.56)μs/mol여(516.67±208.45)μg/mol、(421.13±196.66)μg/mol여(1170.55±414.65)μg/mol、(758.76±326.19)μg/mol여(1739.12±696.08)μg/mol화(29.68±16.32)μg/mol여(49.23±22.50)μg/mol(P균＜0.01);각조혈청、지기관폐포관세액NSE수평분별위(10.36±6.76)mg/mol여(16.66±11.62)mg/mol、(24.19±10.88)mg/mol여(45.47±20.74)mg/mol、(35.76±17.30)mg/mol여(65.18±29.87)mg/mol화(9.70±5.28)mg/mol여(9.70±5.28)mg/mol(P균＜0.01).혈청화지기관폐포관세액ProGRP화NSE수평,Ⅰ～Ⅱ기、Ⅲ기、Ⅳ기조명현고우대조조(P균＜0.01).각조혈청ProGRP검측양성솔분별위60.00%、70.97%、82.86%、6.67%(P균＜0.01),지기관폐포관세액ProGRP검측양성솔분별위63.33%、74.19%、85.71%、4.44%(P균＜0.01);혈청NSE검측양성솔분별위23.33%、67.74%、80.00%、22.22%(P균＜0.01),지기관폐포관세액NSE검측양성솔분별위26.67%、70.97%、82.86%、26.67%(P균＜0.01);Ⅰ～Ⅱ기、Ⅲ기、Ⅳ기조지기관폐포관세액ProGRP화NSE검측양성솔균고우혈청검측,차균수기분기급별제승이증고;단Ⅲ기조화Ⅳ기조비교차이무통계학의의(P＞0.05).결론 혈청화지기관폐포관세액ProGRP급NSE검측대SCLC적진단여TNM분기균유교대적림상개치;대불동TNM분기SCLC적진단,지기관폐포관세액ProGRP화NSE검측우우혈청검측;대SCLC적조기진단혈청화지기관폐포관세액ProGRP검측우우NSE.
Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ～Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P＜0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P＜0.01 ).The serum level of NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P＜0.01).The positive rate of serum ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P＜0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P＜0.01).The positive rate of serum NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P＜0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ～Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P＜0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ～Ⅱ SCLC group were obviously higher than that in the NSE (P＜0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.
