NSE、ProGRP、Ki-67、TTF-1对小细胞肺癌诊断价值的研究  

The study of NSE,ProGRP,Ki-67,TTF-1 in the diagnosis of small cell lung cancer

作　　者：赵红峥[1] 李燕[1] 冯军花[1] 张金艳[1] 郭秀娟[1] 焦文静[1] 何京[1] 

机构地区：[1]河北医科大学第四医院检验科,石家庄050000

出　　处：《国际检验医学杂志》2018年第3期281-285,共5页International Journal of Laboratory Medicine

基　　金：河北省重点科技研究计划(20130254)

摘　　要：目的评价血清肿瘤标志物对小细胞肺癌诊断的应用价值,分析血清肿瘤标志物与病理指标的关系。方法应用电化学发光技术检测癌胚抗原(CEA)、神经元特异性烯醇酶(NSE)、细胞角蛋白19片段(CYFRA21-1),应用免疫发光技术检测促胃秘素释放肽前体(ProGRP),应用MaxVision免疫组化技术检测细胞核相关抗原(Ki-67)和甲状腺转录因子-1蛋白(TTF-1),应用两独立样本秩和检验、秩相关分析、χ2检验及ROC曲线统计数据。结果小细胞肺癌患者血清中CEA、NSE、ProGRP、CYFRA21-1浓度均高于良性疾病患者,SCLC广泛期患者血清中CEA、NSE、ProGRP、CYFRA21-1浓度均高于局限期患者(P<0.05)。NSE和ProGRP的ROC曲线下面积较大,分别为0.972、0.965。NSE+ProGRP检测肿瘤标志物的组合Kappa值0.860,与金标准一致性较好。CEA,NSE,ProGRP与Ki-67存在负相关关系,TTF-1的阳性检测率高于CYFRA21-1,低于ProGRP,CEA、NSE与TTF-1的检测结果比较差异无统计学意义(P>0.05)。结论 NSE与ProGRP联合检测对SCLC的诊断及分期有重要价值,可提高检测SCLC的敏感度和特异度;Ki-67高表达不能反映血清肿瘤标志物的水平,TTF-1对SCLC的检测效果与NSE无差异,但不及ProGRP。Objective To evaluate the application value of serum tumor markers in small cell lung Cancer,and analyse the relationship between serum tumor markers and immunohistochemistry indicators.Methods The electrochemical luminescence technology was used to detect the concentration of carcino-embryonic antigen(CEA),neuronspecific enolase(NSE),cyto-keratin fragment 19(CYFRA21-1),the immunological luminescence technology was used to detect the concentration of ProGRP,the expression of Ki-67,TTF-1 were detected by MaxVision immunohistochemistry methods,the date was analyzed by two independent sample rank sum test,rank correlation methods,chi-square test and ROC curve.Results The concentration of CEA,NSE,progastrin-releasing peptide(ProGRP),CYFRA21-1 in SCLC were higher than that in benign disease,the concentration of CEA,NSE,ProGRP,CYFRA21-1 in extensive stage were higher than that in limited stage(P<0.05),the difference was statistically significant.The ROC area of NSE,ProGRP were large,they were 0.972 and 0.965,the Kappa value of the NSE+ProGRP was 0.860,optimstic data consistency with"the gold standard".There was a negative relationship between Ki-67 and CEA,NSE,ProGRP,the positive rate of TTF-1 was higher than CYFRA21-1,while lower than ProGRP,But NSE,CEA and TTF-1 have same results(P>0.05).Conclusion Combined detection NSE and ProGRP is of great value in the diagnosis and periods of SCLC,the sensibility and specificity of NSE+ProGRP was high in SCLC,he high expression of Ki-67 was not responsed the concentration of serum tumor markers,TTF-1 had the same results with NSE,while inferior to ProGRP in detect of SCLC.

关 键 词：小细胞肺癌 癌胚抗原 神经元特异性烯醇酶 促胃泌素释放肽前体 细胞角蛋白19片段 

分 类 号：R446.6[医药卫生—诊断学]