联合检测血清PCT和NSE对小细胞肺癌的诊断价值

doi:10.6040/j.issn.1671-7554.0.2015.412

摘要/Abstract

摘要： 目的探讨联合检测血清降钙素原(PCT)和神经元特异性烯醇化酶(NSE)对小细胞肺癌的诊断价值。方法将123例排除肺部感染及其他感染史和肝脏等转移的新诊断的住院肺癌患者,分为鳞癌组(n=48)、腺癌组(n=52)与小细胞癌组(n=23),另选择门诊健康体检者作为对照组(n=40),比较各组之间PCT和NSE的水平。结果各组之间PCT和NSE水平相比,差异有统计学意义(P<0.01)。PCT在腺癌组、鳞癌组与小细胞癌组之间的差异有统计学意义(P<0.05),NSE在腺癌组、鳞癌组与小细胞癌组之间的差异有统计学意义(P<0.01)。PCT和NSE区分小细胞肺癌和鳞癌、腺癌的鉴别诊断最佳截断点分别为0.10和23.91 ng/mL,ROC曲线下面积分别为0.671和0.806,敏感性为56.5%和69.6%,特异性为77.0%和90.0%,联合检测(PCT+NSE)可将特异性提高为98.0%,联合检测(PCT或NSE)可将敏感性提高为82.6%。结论检测血清PCT对小细胞肺癌具有一定的鉴别意义,在小细胞肺癌患者中判断细菌感染时,应谨慎判读PCT结果。联合检测PCT和NSE将有助于肺癌的鉴别诊断和组织分型。

关键词: 神经元特异性烯醇化酶, ROC曲线, 降钙素原, 小细胞肺癌

Abstract: Objective To investigate the diagnostic value of combination of procalcitonin(PCT)and neuron-specific enolase(NSE)in serum for differentiating small cell lung cancer from other lung cancers. Methods A total of 123 lung cancer patients without lung infections, other sites infection history and liver metastasis were divided into three groups: squamous carcinoma group(n=48), adenocarcinoma group(n=52)and small cell carcinoma group(n=23). And 40 healthy volunteers were taken as control group. Serum PCT and NSE levels were tested and compared among each group. Results Serum PCT and NSE levels were statistical different among the four groups(P<0.01). Mann-Whitney analysis showed that, there were statistical differences between small cell carcinoma and squamous carcinoma or adenocarcinoma groups(P<0.05, P<0.01). For PCT and NSE, the area under the ROC curve was 0.671 and 0.806, the best cut-off point was 0.10 and 23.91 ng/mL, sensitivity was 56.5% and 69.6%, and specificity was 77.0% and 90.0%. Combination(PCT+NSE)would increase the specificity to 98.0%, while combination(PCT or 山东大学学报 (医学版)54卷11期 -张志强,等.联合检测血清PCT和NSE对小细胞肺癌的诊断价值 \=-NSE)would increase the sensitivity to 82.6%. Conclusion PCT can be used as a marker in differentiating small cell lung cancer from other lung cancers. However, for the small cell lung cancer patients, serum PCT cannot be simply used to detect the infection. Meanwhile, combined biomarkers(PCT and NSE)will improve the diagnostic performance in discrimination of small cell lung cancer.

Key words: Small cell lung cancer, Neuron specific enolase, ROC curve, Procalcitonin

中图分类号:

R734.2

张志强,吴艳华,王茂水,王新锋,汪运山. 联合检测血清PCT和NSE对小细胞肺癌的诊断价值[J]. 山东大学学报（医学版）, 2016, 54(11): 36-39.

ZHANG Zhiqiang, WU Yanhua, WANG Maoshui, WANG Xinfeng, WANG Yunshan. Diagnostic value of combination of PCT and NSE in serum for detecting small cell lung cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(11): 36-39.

参考文献

[1] Assicot M, Gendrel D, Carsin H, et al. High serum procalcitonin concentrations in patients with sepsis and infection[J]. Lancet, 1993, 341(8844): 515-518.
[2] 王信杰,杜向阳.降钙素原与腺苷脱氨酶联合检测诊断结核性胸腔积液[J].山东大学学报(医学版), 2012, 50(9): 79-82. WANG Xinjie, DU Xiangyang. Combined detection of procalcitonin and adenosine deaminase for tuberculous pleural effusion[J]. Journal of Shandong University(Health Sciences), 2012, 50(9): 79-82.
[3] Sandri MT, Passerini R, Leon ME, et al. Procalcitonin as a useful marker of infection in hemato-oncological patients with fever[J]. Anticancer Res, 2008, 28(5B): 3061-3065.
[4] 刘平平,郑力,张浩,等. PCT和C-反应蛋白在恶性肿瘤合并感染的早期诊断价值[J].浙江临床医学, 2014, 16(9): 1383-1384. LIU Pingping, ZHENG Li, ZHANG Hao, et al. PCT and C-reactive protein in early diagnosis of infection in the patients with malignant tumor[J]. Zhejiang Clinical Medical Journal, 2014, 16(9): 1383-1384.
[5] Kallio R, Surcel HM, Bloigu A, et al. C-reactive protein, procalcitonin and interleukin-8 in the primary diagnosis of infections in cancer patients [J]. Eur J Cancer,2000, 36(7): 889-894.
[6] Russwurm S, Stonans I, Stonane E, et al.Procalcitonin and CGRP-1 mrna expression in various human tissues[J]. Shock, 2001, 16(2): 109-112.
[7] 上官红,肖伟,董亮,等.血清CYFRA21-1、NSE和CEA在肺癌诊断和评估预后中的临床价值[J].山东大学学报(医学版), 2010, 48(12): 134-137. SHANGGUAN Hong, XIAO Wei, DONG Liang, et al. Clinical value of serum CYFRA21-1, NSE and CEA in the diagnosis and prognosis of lung cancer [J]. Journal of Shandong University(Health Sciences), 2010, 48(12): 134-137.
[8] 陈孝谦,汪铮,李秀.血清降钙素原对渗出性胸腔积液病因的鉴别价值[J].临床肺科杂志, 2013, 18(8): 1446-1448. CHEN Xiaoqian, WANG Zheng, LI Xiu. Value of serum procalcitonin in the differentiation of causes of pleural exudates [J]. Journal of Clinical Pulmonary Medicine, 2013, 18(8): 1446-1448.
[9] Cate CC, Pettengill OS, Sorenson GD. Biosynthesis of procalcitonin in small cell carcinoma of the lung[J]. Cancer Res, 1986, 46(2): 812-818.
[10] Mehanic S, Baljic R. The importance of serum procalcitonin in diagnosis and treatment of serious bacterial infections and sepsis[J]. Mater Sociomed, 2013, 25(4): 277-281.
[11] 佟威威,佟广辉,王婧,等. Cyfra21-1、NSE、SCCA和CRP在肺癌诊断中的应用[J].中国免疫学杂志, 2015, 31(3): 396-400. TONG Weiwei, TONG Guanghui, WANG Jing, et al. Value of Cyfra21-1, NSE, SCCA and CRP in diagnosis of lung cancer[J]. Chinese Journal of Immunology, 2015, 31(3): 396-400.
[12] Lortet-Tieulent J, Soerjomataram I, Ferlay J, et al. International trends in lung cancer incidence by histological subtype: adenocarcinoma stabilizing in men but still increasing in women[J]. Lung Cancer, 2014, 84(1): 13-22.
[13] Falsey AR, Becker KL, Swinbume AJ, et al. Utility of serum procalcitonin values in patients with acute exacerbations of chronic obstrutive pulmonary disease: a cautionary note[J]. Int J Chron Obstruct Pulmon Dis, 2012, 7: 127-135.
[14] Schuetz P, Maurer P, Punjabi V, et al. Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients[J]. Crit Care, 2013, 17(3): R115-R122.
[15] 叶倩,陈燕,罗玲青,等.血清降钙素原及C反应蛋白在鉴别肿瘤患者发热原因中的价值[J].国际检验医学杂志, 2014, 35(19): 2064-2066. YE Qian, CHEN Yan, LUO Lingqing, et al.The value of serum procalcitonin and C-reactive protein in the differentiation of the causes of fever in cancer patients[J]. International Journal of Laboratory Medicine, 2014, 35(19): 2064-2066.
[16] Ukay I, Garzoni C, Ferry T, et al. Postoperative serum pro-calcitonin and C-reactive protein levels in patients with orthopedic infections[J]. Swiss Med Wkly, 2010, 140: w13124.

相关文章 15

[1]	黄佩文, 王旭东. 治疗非小细胞肺癌新药:靶向c-Met蛋白的抗体药物偶联物Telisotuzumab Vedotin[J]. 山东大学学报 (医学版), 2026, 64(3): 124-130.
[2]	赵汉卿,周新睿,李子建,唐兴. 循环肿瘤细胞联合血清学检测在非小细胞肺癌中的应用[J]. 山东大学学报 (医学版), 2025, 63(5): 79-85.
[3]	徐年兴,魏东,乔俊杰,战炳炎. CD8⁺、IL-6和PaO₂对不可切除Ⅲ_B/C和Ⅳ期非小细胞肺癌免疫治疗触发放射召回性肺炎的预测价值[J]. 山东大学学报 (医学版), 2025, 63(2): 29-35.
[4]	山东省腔镜外科质量控制中心胸腔镜委员会. 山东省VATS/RATS非小细胞肺癌围术期质量控制指标专家共识(2025版)[J]. 山东大学学报 (医学版), 2025, 63(12): 1-5.
[5]	刘振昆,吕纪玲,徐伟伟,马力天,张才擎. BALF tNGS检测及培养对NSCLC合并IPFD的诊断价值[J]. 山东大学学报 (医学版), 2025, 63(11): 36-45.
[6]	张荣雨,赵文,李洪欣,杨闯,王健,韩春燕,李际盛. 奥西替尼联合化疗一线治疗EGFR-RAD51融合突变转移性肺腺癌1例[J]. 山东大学学报 (医学版), 2024, 62(5): 116-120.
[7]	王蕾,向淇,刘学伍. 伴系统性硬化症、类风湿关节炎的副肿瘤神经综合征1例[J]. 山东大学学报 (医学版), 2023, 61(7): 118-120.
[8]	秦静,杨飞,陈谦,夏涵岱,刘延国,王秀问. 晚期驱动基因阴性、PD-L1表达阴性非鳞非小细胞肺癌一线治疗方案的网状Meta分析[J]. 山东大学学报 (医学版), 2022, 60(7): 74-82.
[9]	陈兆波,方敏,薛浩然,刘春艳. 去泛素化酶USP35促进非小细胞肺癌细胞迁移和侵袭[J]. 山东大学学报 (医学版), 2022, 60(4): 30-37.
[10]	马瑞杰,朱良明,左太阳,李春海,张楠,孙志钢. 微波消融治疗非小细胞肺癌根治术后肺寡转移瘤的预后分析[J]. 山东大学学报 (医学版), 2022, 60(12): 63-68.
[11]	刘会宁,彭军,任迎春,杨光,王文豪,刘金锋,田勍. 34例胸腔镜下肺楔形切除与21例肺段切除对位于肺段P区的ⅠA1期非小细胞肺癌治疗比较[J]. 山东大学学报 (医学版), 2022, 60(11): 38-43.
[12]	丁子琛,王浩桦,周立雯,丛慧文,李承圣,包绮晗,杨毅,王廉源,王素珍,石福艳. 基于贝叶斯累加回归树模型的非小细胞肺癌患者个性化疗效研究[J]. 山东大学学报 (医学版), 2022, 60(10): 92-98.
[13]	张喜琴,祝守慧,刘宁,王玉,陈家帧,胡旭东. PEG-rhG-CSF对80例小细胞肺癌同步放化疗预防中性粒细胞减少的临床观察[J]. 山东大学学报 (医学版), 2020, 58(12): 43-46.
[14]	刘小璟,夏西燕,肖珂,陈文丹,庄学伟. 外泌体lncRNA OGFRP1在84例非小细胞肺癌中的表达及临床意义[J]. 山东大学学报 (医学版), 2020, 58(11): 71-75.
[15]	代晓宇,路媛,王志恒,李明卓,司书成,李吉庆, 井明, 薛付忠. 血常规数据判别骨髓增生异常综合征和急性髓样白血病的应用价值[J]. 山东大学学报 (医学版), 2020, 58(1): 20-25.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed