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Purpose:To investigate the diagnostic significance and application value of pro-gastrin-releasing peptide (ProGRP) in early stages of small cell lung cancer (SCLC).Patients and Methods: Serum levels of ProGRP were measured in 451 healthy people, 179 patients with benign pulmonary disease (BPD),365 with NSCLC,245 with SCLC and 194 with other cancers(disqualify those with abnormal ProGRP levels due to renal failure).By using Chemiluminescence Microparticle Immuno Assay (CMIA), serum samples were tested for ProGRP.Statistical calculations were performed using SPSS for windows,version 19 (SPSS Inc., Chicago, IL,USA).P value<0.05 was considered as significant.Results:ProGRP serum levels were significantly higher in SCLC than those in healthy people,BPD, NSCLC and other cancers (for all P<0.0001):median values were 40.7,46.7,40.4,670.5,27.2 pg/ml for healthy people, BPD, NSCLC,SCLC and other cancers,respectively (Table 1).For analyses of the sensitivity-specificity relation of the assay, receiver operating characteristic (ROC) curves were constructed and used as a tool for determination of an optimal cut-off value.The areas under the ProGRP ROC curves and the cut-offs in the model considering SCLC versus healthy people,SCLC versus BPD,SCLC versus NSCLC,and SCLC versus other cancers were: 0.78 and 72.1,0.79 and 64.2,0.80 and 75.1,0.88 and 48.4,respectively (Figure 1, Table 2).Selecting five different thresholds, the positive rate of different disease groups were calculated.The specificity of ProGRP for SCLC was significant: the positive rates of ProGRP values that were greater than five thresholds for SCLC were extremely higher than the others.The majority of ProGRP levels for SCLC were very high: the positive rate of ProGRP values greater than 100,500, 1000pg/ml were 53.9% ,28.6% and 17.1%.While the others were no cases of ProGRP values greater than 500 pg/ml(Fignre 2).Conclusion: ProGRP is a sensitive and specific marker in SCLC,with diagnostic performance better than other markers.The high value of ProGRP may be a characteristics indicator of SCLC.