慢性肾脏病对血清胃泌素释放肽前体测定的影响  

The Influence of Chronic Kidney Disease on the Detecting Result of Serum ProGRP

作　　者：陆明洋[1] 徐斌[1] 李敏[1] 刘检[1] 郑晓[1] 蒋敬庭[1] LU Ming-yang;XU Bin;LI Min;LIU Jian;ZHENG Xiao;JIANG Jing-ting(Department of Tumor Biotherapy,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院肿瘤生物诊疗中心

出　　处：《标记免疫分析与临床》2019年第9期1524-1527,共4页Labeled Immunoassays and Clinical Medicine

基　　金：国家自然科学基金(编号:31570877);国家重点研发计划(编号:2018YFC1313400)

摘　　要：目的探讨慢性肾脏病(CKD)对血清胃泌素释放肽前体(ProGRP)测定的影响。方法采用化学发光微粒子免疫检测法(CMIA)测定ProGRP,采用碱性苦味酸法测定肌酐(Cr),根据简化MDRD公式计算估算肾小球滤过率(eGFR),根据eGFR确定CKD分期。分别检测了112例慢性肾脏病、34例原发性小细胞肺癌(SCLC)和75例健康体检者血清。结果ProGRP与Cr水平呈正相关(r=0.560,P<0.01),ProGRP与eGFR呈显著负相关(r=-0.798,P<0.01)。健康对照组、慢性肾脏病组、小细胞肺癌组,三组间ProGRP水平差异有统计学意义(F=75.876,P<0.01)。随着慢性肾脏病的进展,ProGRP水平逐渐增高(F=57.272,P<0.01)。小细胞肺癌组与CKD5期ProGRP水平比较差异无统计学意义(P>0.05),与其余CKD各分期比较差异均有统计学意义(P<0.01)。当确定ProGRP最佳截断值为290.91 pg/mL时,其对SCLC与CKD5的鉴别,特异性达98.4%。结论慢性肾脏病患者血清ProGRP水平可大幅度升高,ProGRP用于小细胞肺癌的辅助诊断时需排除慢性肾脏病引起的肾小球损伤导致的血清ProGRP升高。Objective To investigate the influence of chronic kidney disease(CKD)on the results of detecting serum pro-gastrin releasing peptide(ProGRP).Methods In the current study,we collected serum from 112 CKD patients,34 small cell lung cancer(SCLC)patients and 75 healthy individuals.ProGRP was detected by chemiluminescent microparticle immunoassay(CMIA).Creatinine was detected by Jaffe assay.Estimated glomeruar filtration rate(eGFR)was calculated by simplified MDRD formula,and we determined the stages of CKD by eGFR.Results The serum level of ProGRP was positively correlated with Cr(r=0.560,P<0.01),while negatively correlated with eGFR(r=-0.798,P<0.01).Across CKD patients,SCLC patients and healthy individuals,the serum levels of ProGRP showed significant differences(F=75.876,P<0.01).The serum level of ProGRP gradually increased by the progression of CKD(F=57.272,P<0.01).The serum level of ProGRP in SCLC patients showed no significant difference compared to CKD5(P>0.05),while showed significant differences compared to other stages of CKD(P<0.01).When distinguishing SCLC and CKD5,we found the optimal cut-off value of ProGRP was 290.91pg/mL,and the specificity was 98.4%.Conclusion The serum level of ProGRP in CKD patients could be significantly increased,so when ProGRP was used to facilitate the diagnosis of SCLC,the glomerular injury by CKD should be excluded.

关 键 词：慢性肾脏病 小细胞肺癌 胃泌素释放肽前体 化学发光法 肌酐 

分 类 号：R73[医药卫生—肿瘤]