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小细胞肺癌占所有肺癌的25%。研究表明,小细胞肺癌的癌细胞会分泌具有高度特异性的神经肽,胃泌素释放肽前体(ProGRP:Pro-Gastrin-Releasing Peptide)。ProGRP诊断小细胞肺癌具有高灵敏度(最高可达到86%)和高特异性(肾功能正常情况下,ProGRP在150 pg/mL左右对于小细胞肺癌的诊断特异性近100%)。与CEA、CYFRA 21-1、NSE及嗜铬粒蛋白A等其他肺癌相关肿瘤标志物相比,ProGRP在释放量、肿瘤特异性及器官特异性都占有优势。由于在发生良性病变及其他癌症(包括非小细胞肺癌在内)时,没有ProGRP产生或产生量很少,因此ProGRP检测对于鉴别诊断有很大帮助。由于ProGRP的释放不依赖于肿瘤分期,所以该标志物可用于高危人群(如,吸烟者)的筛查。此外,ProGRP对于复发癌症的检出灵敏度高达74%,高于NSE(32%)及CEA(56%)的监测表现,成为小细胞肺癌病变进展最明确的指标。由此可见,ProGRP是一种作常罕见的小细胞肺癌生物学标志物,有重要诊断应用价值。本文就此方面研究现状作一概述。
Small cell lung cancer accounts for 25% of all lung cancers. Studies have shown that cancer cells of small cell lung cancer secrete a highly specific neuropeptide, Pro-Gastrin-Releasing Peptide. ProGRP diagnoses small cell lung cancer with high sensitivity (up to 86%) and high specificity (ProGRP has a diagnostic specificity of nearly 100% for small cell lung cancer at around 150 pg / mL with normal renal function). Compared with other lung cancer-associated tumor markers such as CEA, CYFRA 21-1, NSE, and chromogranin A, ProGRP is predominant in terms of release, tumor specificity, and organ specificity. Since ProGRP is not produced or produced in small amounts in the development of benign lesions and other cancers, including non-small cell lung cancer, the ProGRP test can be of great help in differential diagnosis. Since release of ProGRP is independent of tumor stage, this marker can be used to screen for at-risk populations such as smokers. In addition, the detection sensitivity of ProGRP for recurrent cancer is as high as 74%, which is higher than that of NSE (32%) and CEA (56%) and is the most clear indicator of the progression of small cell lung cancer. Thus, ProGRP is a rare and common small cell lung cancer biological markers, there is an important diagnostic value. This article gives an overview of the status quo in this regard.