血清胃泌素释放肽前体联合其他肿瘤标志物在肺癌诊断中的应用  

Diagnostic Value of Serum Pro GRP and Other Tumor Markers in Lung Cancer

作　　者：郭青丽 薛海斌[2] 孙凤强 焦红娟 李世荣[2] 

机构地区：[1]潍坊医学院临床检验诊断学教研室,山东潍坊261053 [2]潍坊市人民医院检验科

出　　处：《潍坊医学院学报》2017年第6期433-436,共4页Acta Academiae Medicinae Weifang

摘　　要：目的探讨胃泌素释放肽前体(Pro GRP)及神经特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、胚胎性癌抗原(CEA)这4种肿瘤标志物及联合检测在肺癌诊断中的应用价值。方法选取初诊的小细胞肺癌(SCLC)63例,非小细胞肺癌(NSCLC)56例,肺部良性疾病患者(BPD)40例及健康对照者70例,采用罗氏电化学发光技术检测患者血清中Pro GRP和NSE,CYFRA21-1,CEA的含量。结果 4种肿瘤标志物表达水平都显著高于肺部良性疾病组及健康对照组,差异均具有统计学意义(P<0.05),4种肿瘤标志物联合检测诊断肺癌的ROC-AUC为0.986、敏感度为96.77%,高于各单项及3者联合检测的ROC-AUC及敏感度,但特异度仅为88.6%;Pro GRP,CYFRA21-1,CEA联合检测的ROC-AUC为0.945、敏感度为87.5%,要比NSE,CYFRA21-1,CEA联合检测的ROC-AUC及敏感性低,但特异性高。Pro GRP高表达于SCLC患者血清中,诊断SCLC的ROC-AUC为0.942,敏感度及特异度分别为92.06%和98.6%;NSE诊断SCLC的ROC-AUC为0.866,敏感度及特异度分别为90.5%和95.7%.CYFRA21-1诊断肺鳞癌的ROC-AUC为0.636,敏感度及特异度分别为82.61%和95.7%;诊断肺腺癌的ROC-AUC为0.552、敏感度及特异度分别为64.71%和95.7%.结论 Pro GRP诊断SCLC的价值高于NSE;4种肿瘤标志物联合检测对肺癌的诊断价值高于各单项及3项联合检测,且根据联合检测中各项的表达含量的差异,对肺癌分型有良好的预估价值。Objective To explore the diagnostic value of Pro-gastrin-releasing peptide precursor（ Pro GRP） and neural specificity enolization enzyme（ NSE）,Cytokeratin 19 fragment antigen 21-1（ CYFRA21-1）,carcinoembryonic antigen（ CEA） in lung cancer. Methods From December 2016 to May 2017,63 cases of small cell lung cancer（ SCLC）,56 cases of non-small cell lung cancer（ NSCLC）,40 cases of benign lung disease（ BPD） and 70 cases of healthy controls were selected. And Pro GRP,NSE,CYFRA21-1,and CEA in patients＇ serum were checked by Roche Electrochemiluminescence. Results The expression levels of four tumor markers were significantly higher than those of the control group,the difference was statistically significant（ P〈0. 05）. Pro GRP,NSE,CYFRA21-1,CEA combined detection of lung cancer ROC-AUC was 0. 986,the sensitivity was 96. 77%,was higher than the individual detection and 3 joint detection,but the specificity was only88. 6%; The ROC-AUC of Pro GRP,CYFRA21-1 and CEA combined detection was 0. 945 and the sensitivity was 87. 5%,which was lower than that of NSE,CYFRA21-1 and CEA combined detection,but the sensitivity was high. Pro GRP was highly expressed in serum of SCLC patients,and the ROC-AUC was 0. 942,the sensitivity and specificity were 92. 06% and 98. 6%; The ROC-AUC of NSE was 0. 866,sensitivity and specificity were 90. 5% and 95. 7%. CYFRA21-1 diagnosis of squamous cell carcinoma ROC-AUC was 0. 636,sensitivity and specificity were 95. 7% and 82. 61%; the diagnosis of pulmonary adenocarcinoma ROC-AUC was 0. 552,sensitivity and specificity were 95. 7% and 64.71%. Conclusion The value of Pro GRP diagnostic SCLC is higher than that of NSE. The diagnostic value of Pro GRP and CEA,CYFRA21-1,NSE combined detection in patients with lung cancer is higher than that in the single test and 3 joint tests. And according to the difference between the expression levels of each item in the joint test is good predictive value for pathology.

关 键 词：肺癌 血清胃泌素释放肽前体 神经特异性烯醇化酶 细胞角蛋白19片段 抗原胚胎性癌抗原 

分 类 号：R734.2[医药卫生—肿瘤]