胃泌素释放肽前体在肺癌诊断中的临床意义

发布时间：2018-06-17 14:13

  本文选题：胃泌素释放肽前体 + NSE　； 参考：《安徽医科大学》2015年硕士论文

【摘要】：目的通过观察小细胞肺癌(small cell lung cancer,SCLC)患者、非小细胞肺癌(non-small cell lung cancer,NSCLC)患者、健康体检人群的血清神经源特异性烯醇化酶(neuron specific enolase,NSE)、胃泌素释放肽前体(progastfin releasing peptide,ProGRP)的检测结果,探讨ProGRP的表达对肺癌诊断的临床意义。方法收集105例住院肺癌初治患者的血清标本,另取同期46例本院健康体检者血清标本作为健康对照组。采用电化学发光免疫法(Electrochemiluminescence immunoassay,ECLI)测定血清NSE、血清ProGRP的浓度。统计学分析采用t检验和卡方检验,相关分析采用Pearson直线相关分析。对ProGRP和NSE的诊断价值采用ROC曲线,血清ProGRP和NSE两组间定量资料相关性分析。结果1.肺癌组血清ProGRP浓度(243.49±770.04)pg/mL,高于健康对照组血清ProGRP浓度(45.68±27.56pg/mL),且P0.05。肺癌组血清NSE浓度为(42.94±137.15)μg/L,健康对照组血清NSE浓度为(13.00±5.95)μg/L,且P0.05。2.SCLC组患者血清ProGRP及血清NSE阳性率明显高于NSCLC组及健康对照组,且ProGRP在SCLC中阳性率大于NSE在SCLC阳性率;ProGRP在NSCLC及健康对照组的阳性率小于NSE的阳性率。与血清NSE相比,血清ProGRP诊断SCLC的特异性、阳性预测值、阴性预测值、敏感度、特异度、约登指数及诊断准确率均较高。ProGRP与NSE的联合诊断的敏感度较ProGRP和NSE单独检测较高,而联合检测两者的阳性预测值、阴性预测值、特异度、约登指数及诊断准确率介于ProGRP和NSE单独检测之间。3.研究显示ProGRP诊断SCLC的ROC曲线下面积为0.813,其面积的95%可信区间为(0.702,0.925),差异具有统计学意义(P0.001);NSE诊断SCLC的ROC曲线下面积为0.790,其面积的95%可信区间为(0.675,0.904),差异具有统计学意义(P0.001)。4.直线相关分析表明:SCLC患者血清中PROGRP与血清NSE水平呈正相关(r=-0.442,p=0.013,差异具有统计学意义)。5.应用单因素卡方检验分析检测结果显示:肺癌患者ProGRP水平与患者组织病理类型(本研究将病理类型归纳为NSCLC组和SCLC组)及肺癌患者血清NSE水平相关。与患者年龄(χ2值=0.446,P值等于0.601)、性别(χ2值=2.722,P值等于0.115)、吸烟史(χ2值=2.448,P值等于0.118)、TNM分期(χ2值=0.007,P值等于0.932)、转移淋巴结数(χ2值=0.455,P值等于0.500)、远处转移的有无(χ2值=0.281,P值等于0.596)比较,P值均大于0.05,差异无统计学意义,认为肺癌患者ProGRP水平与患者年龄、性别、吸烟史、TNM分期、转移淋巴结数、远处转移无明显关系。结论ProGRP水平在SCLC早期升高,ProGRP对SCLC的鉴别诊断具有重要意义,对ProGRP升高的NSCLC患者应在排除影响因素后针对肿瘤细胞的神经内分泌特性调整临床决策。对确诊SCLC的患者,在规范放化疗的同时,应定期随访ProGRP的浓度,以更好对SCLC患者的疗效进行检测,预测疾病复发等。
[Abstract]:Objective to investigate the results of the detection of serum neurogenic specific enolase (neuron specific) and gastrin releasing peptide precursors in healthy people by observing the patients with small cell lung cancer (SCLC) and non small cell lung cancer (non-small cell lung cancer, NSCLC). The clinical significance of the expression of roGRP in the diagnosis of lung cancer. Methods the serum specimens of 105 patients with lung cancer in the first treatment were collected, and the serum samples of 46 healthy persons in the same period were taken as the healthy control group. The serum NSE and the concentration of serum ProGRP were measured by electrochemiluminescence immunoassay (Electrochemiluminescence immunoassay, ECLI). T test and chi square test were used to analyze the correlation analysis using Pearson linear correlation analysis. The diagnostic value of ProGRP and NSE was based on the ROC curve, serum ProGRP and NSE two groups. Results 1. the serum ProGRP concentration (243.49 + 770.04) pg/mL in the lung cancer group and the serum ProGRP concentration (45.68 + 27.56pg/mL) in the Gao Yujian Kang control group (45.68 + 27.56pg/mL), and P0. 5 the serum concentration of NSE in the lung cancer group was (42.94 + 137.15) mu g/L, and the serum NSE concentration in the healthy control group was (13 + 5.95) g/L, and the positive rate of serum ProGRP and serum NSE in the P0.05.2.SCLC group was significantly higher than that in the NSCLC group and the healthy control group, and the positive rate of ProGRP in SCLC was greater than NSE in the SCLC positive rate. The positive rate of less than NSE. Compared with the serum NSE, the specificity, the positive predictive value, the negative predictive value, the sensitivity, the specificity, the Jordan index and the diagnostic accuracy of the serum ProGRP diagnosis of SCLC were higher than those of the.ProGRP and NSE, which were higher than those of ProGRP and NSE, while the positive predictive value of both and the negative predictive values were combined. The specificity, the Jordan index and the diagnostic accuracy between the ProGRP and NSE separate tests showed that the area of the ROC curve under the ProGRP diagnosis SCLC was 0.813, and the 95% confidence interval of the area was (0.702,0.925), the difference was statistically significant (P0.001); the area under the ROC curve of NSE diagnostic SCLC was 0.790, and the 95% confidence interval of its area was (0.675,0.). 904) the difference was statistically significant (P0.001).4. linear correlation analysis showed that the serum PROGRP in SCLC patients was positively correlated with the serum NSE level (r=-0.442, p=0.013, the difference was statistically significant) and the.5. application single factor chi square test analysis showed that the level of ProGRP and the histopathological type of the patients with lung cancer (this study was the pathological class. Type NSCLC and SCLC groups were associated with serum NSE levels in patients with lung cancer (x 2 value =0.446, P value equal to 0.601), sex (x 2 =2.722, P value equal to 0.115), smoking history (x 2 =2.448, P equal to 0.118), TNM staging (chi 2 value =0.007, P value equal to 0.932), metastatic lymph nodes (2 value equal to 0.500), distant metastasis of 0.500). No (x 2 value =0.281, P value equal to 0.596) compared, P value is more than 0.05, the difference is not statistically significant, the ProGRP level of lung cancer patients with age, sex, smoking history, TNM stage, the number of metastatic lymph nodes, distant metastasis. Conclusion ProGRP level in the early stage of SCLC increases, ProGRP is of important significance for the differential diagnosis of SCLC, ProGRP for ProGRP. The patients with elevated NSCLC should adjust the clinical decision-making to the neuroendocrine characteristics of the tumor cells after eliminating the factors. For patients with SCLC, the concentration of ProGRP should be regularly followed up in order to better detect the curative effect of the SCLC patients and predict the recurrence of the disease.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2

【参考文献】

相关期刊论文 前2条

1 Petra STIEBER;;胃泌素释放肽前体(Pro-GRP)——小细胞肺癌诊断标志物(英文)[J];中国肺癌杂志;2009年03期

2 张志平;陈名声;任丽芬;刘田;卢宝弼;郝晓柯;;联合检测血清胃泌素释放肽前体和特异性组织多肽抗原在小细胞肺癌诊断中的临床价值[J];现代肿瘤医学;2009年09期

，

本文编号：2031330