ProGRP、NSE、cyfra21-1及其联合因子对小细胞肺癌的诊断价值  

Diagnostic value of ProGRP, NSE and cyfra21-1 as well as their combined factors for small cell lung cancer

作　　者：李广平 张蕾 刘华群[3] 李松林 Li Guangping;Zhang Lei;Liu Huaqun;Li Songlin(Department of Laboratory,Tangshan Workers′Hospital,Tangshan 063000,China;Department of Respiration,Tangshan Workers′Hospital,Tangshan 063000,Ch;Department of Oncology,Tangshan Workers′Hospital,Tangshan 063000,China)

机构地区：[1]唐山市工人医院检验科,唐山063000 [2]唐山市工人医院呼吸科,唐山063000 [3]唐山市工人医院肿瘤科,唐山063000

出　　处：《国际呼吸杂志》2022年第11期862-867,共6页International Journal of Respiration

基　　金：2020年度河北省医学科学研究课题计划(20201496)。

摘　　要：目的研究血清胃泌素释放肽前体(ProGRP)、神经元特异性烯醇化酶(NSE)及细胞角蛋白19片段(cyfra21-1)水平对小细胞肺癌(SCLC)鉴别价值及疗效评估。方法本研究为病例对照研究, 采用非随机抽样法, 选取2019年3月至2020年12月于唐山市工人医院治疗的SCLC患者93例为研究组, 同时选取同期良性肺疾病患者88例作为对照组。检验血清ProGRP、NSE及cyfra21-1水平, 比较2组血清ProGRP、NSE及cyfra21-1水平的差异, 分析ProGRP、NSE及cyfra21-1对SCLC的诊断效能。结果研究组血清ProGRP[98.98(51.09, 160.15)]μg/L、NSE(23.06±6.38)μg/L及cyfra21-1[5.62(4.80, 6.63)μg/L]水平均高于对照组, 差异均有统计学意义(t/Z值分别为-6.914、8.71、9.89, P值均<0.001)。对93例患者进行4周的放化疗, 与治疗前比较, 治疗后ProGRP[112.86(53.01, 152.82)]μg/L、NSE[58.36(44.41, 67.49)]μg/L、cyfra21-1[2.38(1.82, 3.19)]μg/L水平均降低, 差异均有统计学意义(t/Z值为-110.072、-11.779、8.36, P值均<0.001)。NSE与ProGRP、cyfra21-1呈正相关(r值分别为0.57、0.51, P<0.001), ProGRP与cyfra21-1呈正相关(r=0.45, P<0.001)。以SCLC作为状态变量, 血清ProGRP、NSE及cyfra21-1水平为检验变量, 建立二元Logistic回归模型, 得出模型系数的Omnibus检验表(χ^(2)=141.95, P<0.05), 而模型R2=0.725, 得到联合因子的预测值有效。模型方程式为联合因子(Y)=7.693-0.222×NSE-0.017×ProGRP-0.63×cyfra21-1。绘制血清ProGRP、NSE及cyfra21-1水平及联合因子受试者工作特征曲线, 曲线下面积:联合因子>cyfra21-1>NSE>ProGRP(Z=1.000, P=0.317), 敏感度:ProGRP>联合因子>NSE>cyfra21-1(χ^(2)=12.00, P=0.213), 特异度:cyfra21-1>联合因子>NSE>ProGRP(χ^(2)=12.00, P=0.213)。结论 NSE、ProGRP、cyfra21-1均对SCLC有诊断价值, 联合应用更具优越性。Objective To study the differential value of serum progastrin-releasing peptide(ProGRP),neuron-specific enolase(NSE)and cytokeratin 19 fragment(cyfra21-1)levels in small cell lung cancer(SCLC).Methods This study is a case-control,non-randomized study.From March 2019 to December 2020,a total of 93 SCLC patients(study group)and 88 patients with benign lung disease(control group)were respectively enrolled,those patients were admitted to Tangshan Workers′Hospital at the same time.The levels of serum ProGRP,NSE and cyfra21-1 were detected,and the in-group differences of serum ProGRP,NSE and cyfra21-1 level were compared,the diagnostic efficacy of ProGRP,NSE and cyfra21-1 for SCLC were analyzed.Results Serum ProGRP(98.98[51.09,160.15]μg/L),NSE([23.06±6.38]μg/L)and cyfra21-1(5.62[4.80,6.63]μg/L)levels in the study group were higher than those in the control group,the differences were statistically significant(t/Z values were-6.914,8.71,9.89,respectively;all P<0.001).After 93 SCLC patients received 4-week chemoradiotherapy,ProGRP(112.86[53.01,152.82]μg/L),NSE(58.36[44.41,67.49]μg/L),cyfra21-1(2.38[1.82,3.19]μg/L)levels were significantly decreased than before treatment(Z-scores of-110.072,-11.779,8.36,respectively;all P<0.001).NSE was positively correlated with ProGRP and cyfra21-1(r values were 0.57,0.51,respectively,P<0.001),and ProGRP was positively correlated with cyfra21-1(r=0.45,P<0.001).The binary logistic regression model was developed with SCLC parameter as status variable and the index of serum ProGRP,NSE and cyfra21-1 levels as test variables,resulting in an omnibus test table of model coefficients(χ^(2)=141.95,P<0.05),while model R2=0.725,yielding a valid predictive value for the combined factors.The model equations were obtained as joint factor(Y)=7.693-0.222×NSE-0.017×ProGRP-0.63×cyfra21-1.The receiver operating characteristic(ROC)curves of serum ProGRP,NSE and cyfra21-1 levels and combined factors were plotted and showed that the areas under curve(AUC)of combined factor>cyfra21-1>NSE>ProGRP(Z=

关 键 词：小细胞肺癌 胃泌素释放肽前体 神经元特异性烯醇化酶 细胞角蛋白19片段 

分 类 号：R734.2[医药卫生—肿瘤]