本文選題：胃泌素釋放肽前體 + NSE��； 參考：《安徽醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的通過觀察小細(xì)胞肺癌(small cell lung cancer,SCLC)患者、非小細(xì)胞肺癌(non-small cell lung cancer,NSCLC)患者、健康體檢人群的血清神經(jīng)源特異性烯醇化酶(neuron specific enolase,NSE)、胃泌素釋放肽前體(progastfin releasing peptide,ProGRP)的檢測(cè)結(jié)果,探討ProGRP的表達(dá)對(duì)肺癌診斷的臨床意義。方法收集105例住院肺癌初治患者的血清標(biāo)本,另取同期46例本院健康體檢者血清標(biāo)本作為健康對(duì)照組。采用電化學(xué)發(fā)光免疫法(Electrochemiluminescence immunoassay,ECLI)測(cè)定血清NSE、血清ProGRP的濃度。統(tǒng)計(jì)學(xué)分析采用t檢驗(yàn)和卡方檢驗(yàn),相關(guān)分析采用Pearson直線相關(guān)分析。對(duì)ProGRP和NSE的診斷價(jià)值采用ROC曲線,血清ProGRP和NSE兩組間定量資料相關(guān)性分析。結(jié)果1.肺癌組血清ProGRP濃度(243.49±770.04)pg/mL,高于健康對(duì)照組血清ProGRP濃度(45.68±27.56pg/mL),且P0.05。肺癌組血清NSE濃度為(42.94±137.15)μg/L,健康對(duì)照組血清NSE濃度為(13.00±5.95)μg/L,且P0.05。2.SCLC組患者血清ProGRP及血清NSE陽性率明顯高于NSCLC組及健康對(duì)照組,且ProGRP在SCLC中陽性率大于NSE在SCLC陽性率;ProGRP在NSCLC及健康對(duì)照組的陽性率小于NSE的陽性率。與血清NSE相比,血清ProGRP診斷SCLC的特異性、陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、敏感度、特異度、約登指數(shù)及診斷準(zhǔn)確率均較高。ProGRP與NSE的聯(lián)合診斷的敏感度較ProGRP和NSE單獨(dú)檢測(cè)較高,而聯(lián)合檢測(cè)兩者的陽性預(yù)測(cè)值、陰性預(yù)測(cè)值、特異度、約登指數(shù)及診斷準(zhǔn)確率介于ProGRP和NSE單獨(dú)檢測(cè)之間。3.研究顯示ProGRP診斷SCLC的ROC曲線下面積為0.813,其面積的95%可信區(qū)間為(0.702,0.925),差異具有統(tǒng)計(jì)學(xué)意義(P0.001);NSE診斷SCLC的ROC曲線下面積為0.790,其面積的95%可信區(qū)間為(0.675,0.904),差異具有統(tǒng)計(jì)學(xué)意義(P0.001)。4.直線相關(guān)分析表明:SCLC患者血清中PROGRP與血清NSE水平呈正相關(guān)(r=-0.442,p=0.013,差異具有統(tǒng)計(jì)學(xué)意義)。5.應(yīng)用單因素卡方檢驗(yàn)分析檢測(cè)結(jié)果顯示:肺癌患者ProGRP水平與患者組織病理類型(本研究將病理類型歸納為NSCLC組和SCLC組)及肺癌患者血清NSE水平相關(guān)。與患者年齡(χ2值=0.446,P值等于0.601)、性別(χ2值=2.722,P值等于0.115)、吸煙史(χ2值=2.448,P值等于0.118)、TNM分期(χ2值=0.007,P值等于0.932)、轉(zhuǎn)移淋巴結(jié)數(shù)(χ2值=0.455,P值等于0.500)、遠(yuǎn)處轉(zhuǎn)移的有無(χ2值=0.281,P值等于0.596)比較,P值均大于0.05,差異無統(tǒng)計(jì)學(xué)意義,認(rèn)為肺癌患者ProGRP水平與患者年齡、性別、吸煙史、TNM分期、轉(zhuǎn)移淋巴結(jié)數(shù)、遠(yuǎn)處轉(zhuǎn)移無明顯關(guān)系。結(jié)論P(yáng)roGRP水平在SCLC早期升高,ProGRP對(duì)SCLC的鑒別診斷具有重要意義,對(duì)ProGRP升高的NSCLC患者應(yīng)在排除影響因素后針對(duì)腫瘤細(xì)胞的神經(jīng)內(nèi)分泌特性調(diào)整臨床決策。對(duì)確診SCLC的患者,在規(guī)范放化療的同時(shí),應(yīng)定期隨訪ProGRP的濃度,以更好對(duì)SCLC患者的療效進(jìn)行檢測(cè),預(yù)測(cè)疾病復(fù)發(fā)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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R734.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Petra STIEBER;;胃泌素釋放肽前體(Pro-GRP)——小細(xì)胞肺癌診斷標(biāo)志物(英文)[J];中國(guó)肺癌雜志;2009年03期

2 張志平;陳名聲;任麗芬;劉田;盧寶弼;郝曉柯;;聯(lián)合檢測(cè)血清胃泌素釋放肽前體和特異性組織多肽抗原在小細(xì)胞肺癌診斷中的臨床價(jià)值[J];現(xiàn)代腫瘤醫(yī)學(xué);2009年09期

，

本文編號(hào)：2031330