CAJ | 학술논문

目的探讨小细胞肺癌(SCLC)患者血清神经元性烯醇化酶(NSE)与ProGRP(31-98)水平同步检测的临床价值及其相关性.方法采用酶联免疫吸附法(ELISA)对159例SCLC患者、97例肺部良性疾病患者、100名健康人进行血中ProGRP(31-98)与NSE水平的检测.结果 SCLC治疗前NSE与ProGRP(31-98)的中位值分别为21.33μg/L和323.70 pg/ml,肺部良性疾病分别为4.24μg/L和11.94pg/ml,健康人分别为5.82μg/L和8.54pg/ml,3组间比较差异均有统计学意义(均P＜0.001);以NSE 10.35μg/L和ProGRP(31-98)47.98pg/ml为界值,敏感度分别为71.1%和88.7%,特异度分别为95.5%和96.9%,两项联合检测的敏感度和特异度分别为95.6%和96.8%.SCLC局限期和广泛期NSE中位值分别为14.75μg/L和34.10μg/L,敏感度分别为51.14%和93.44%,ProGRP(31-98)中位值分别为143.14pg/ml和1061.14pg/ml,敏感度分别为80.61%和98.61%.治疗后缓解和部分缓解的患者两项血清水平较治疗前明显下降,差异有统计学意义(P＜0.001),未缓解和进展期的患者治疗前后无明显变化.SCLC患者NSE和ProGRP(31-98)血清水平的检测有显著相关性(r=0.379,P＜0.01).结论 NSE和ProGRP(31-98)血清水平有明显的相关性,作为SCLC治疗前诊断和疗效观察均有一定的指导意义,但ProGRP(31-98),特别是对早期SCLC的诊断有更好的敏感性和准确度,两项联合可进一步提高检测的阳性率和有效性.
목적 탐토소세포폐암(SCLC)환자혈청신경원성희순화매(NSE)여ProGRP(31-98)수평동보검측적림상개치급기상관성.방법 채용매련면역흡부법(ELISA)대159례SCLC환자、97례폐부량성질병환자、100명건강인진행혈중ProGRP(31-98)여NSE수평적검측.결과 SCLC치료전NSE여ProGRP(31-98)적중위치분별위21.33μg/L화323.70 pg/ml,폐부량성질병분별위4.24μg/L화11.94pg/ml,건강인분별위5.82μg/L화8.54pg/ml,3조간비교차이균유통계학의의(균P＜0.001);이NSE 10.35μg/L화ProGRP(31-98)47.98pg/ml위계치,민감도분별위71.1%화88.7%,특이도분별위95.5%화96.9%,량항연합검측적민감도화특이도분별위95.6%화96.8%.SCLC국한기화엄범기NSE중위치분별위14.75μg/L화34.10μg/L,민감도분별위51.14%화93.44%,ProGRP(31-98)중위치분별위143.14pg/ml화1061.14pg/ml,민감도분별위80.61%화98.61%.치료후완해화부분완해적환자량항혈청수평교치료전명현하강,차이유통계학의의(P＜0.001),미완해화진전기적환자치료전후무명현변화.SCLC환자NSE화ProGRP(31-98)혈청수평적검측유현저상관성(r=0.379,P＜0.01).결론 NSE화ProGRP(31-98)혈청수평유명현적상관성,작위SCLC치료전진단화료효관찰균유일정적지도의의,단ProGRP(31-98),특별시대조기SCLC적진단유경호적민감성화준학도,량항연합가진일보제고검측적양성솔화유효성.
Objective To study the clinical values and relativity of serum levels of NSE and ProGRP (P31-98) in patients with small-cell lung cancer. Methods Serum levels of NSE and ProGRP (31-98) was measured by ELISA in 159 patients with small cell lung cancer(SCLC), 99 patients with benign lung diseases, and 100 healthy subjects, 141 SCLC patients before and after treatment were also measured. Results The medians of NSE and ProGRP (31-98) was 21.33 μg/L and 323.70 pg/ml in patients with SCLC, 4.24 μg/L and 11.94 pg/ml in patients with benign lung diseases, 5.82 μg/L and 8.54 pg/ml in healthy subjects respectively,significantly increased in patients with SCLC as compared to that of the other two groups (P ＜0.01).Given the cut-off levels of 10.35 pg/L for NSE and 47.98 pg/ml for ProGRP(31-98), the sensitivity of diagnosis in SCLC was 71.1% and 88.7 %, respectively.The combination sensitivity and specificity of NSE and ProGRP(31-98)was 95.6 % and 96.8 %. The medians of NSE in SCLC patients with extensive and limited disease was 14.75 μg/L and 34.10 μg/L, the sensitivity was 51.14 % and 93.44 %, respectively; ProGRP (31-98) in the two groups was 143.14 pg/ml and 1061.14 pg/ml, 80.61% and 98.61%, respectively.In SCLC patients with remission after treatment the levels of NSE and ProGRP31-98 was significantly lower than that before treatment, but the levels without remission had no significantly change. There was significant relationship between NSE and ProGRP(31-98) in serum levels of patients with SCLC (r =0.379, P ＜0.01).Conclusion The serum levels of NSE and ProGRP (31-98) in patients are both increased, there are a significant relationship.But ProGRP(31-98) is a more specific and sensitive marker than NSE for the diagnosis of SCLC.The combination of the two markers can improve positive rate and validity.