The Application With Combinated Detection Of Pro-GRP,CEA,SCC-Ag And NSE In The Diagnosis Of Lung Cancer

TM is produced by autocrine of tumor or from the interaction beween tumor and its host which reside in humour, tissue or cells and indicate that neoformation comes out. Pro-GRP is a kind of TM newfound recently years which is the prosoma of GRP. GRP is an effective secretogogue or regulatory peptide of gastrointestinal hormone, which is secreted form many SCLC cell line and tumor tissue and is an important marker of SCLC. Pro-GRP molecules have common terminatio sequence (31-98) and their level represents the level of GRP.This experiment test 90 lung cancer patients'serum concentration of Pro-GRP by enzme linked immunosorbent assay to raise the lung cancer's detection rate,to distinguish the lung cancer and to choose and apply reasonably. Conclusion:1.The results show that both of the serum concentration of Pro-GRP in lung cancer group(22.44±6.66ng/ml) and positive rate(60%)are higher than benign lung disease group and normal control group, the differences are both significant, P<0.05. When Pro-GRP is 16.93ng/ml ,the sensitivity is 82.85%, the specificity is 76.67%, and the area under the ROC curve can reach 0.793 at most, that can act as threshold value to differentiate lung cancer and benign diseases. 2.Both of the serum concentration of Pro-GRP in SCLC group (28.16±6.73ng/ml) and the positive rate(80%) are higher than ACL group and LSC group, and the differences are significant, P<0.05. When Pro-GRP is 23.97ng/ml ,the sensitivity is 69.4% ,the specificity is 76.7%,and the area under the ROC curve can reach 0.772 at most, that can act as threshold value to differentiate SCLC or not. 3.The serum concentration of Pro-GRP in TNMⅢ+Ⅳstage is higher thanⅠ+Ⅱstage, and the difference is significant. And it is important to the effect observation and prognosis determination of the lung cancer.According the complementary characteristics between TM, this study combine chemoluminescence for CEA and euzymelinked immunosorbent assay for SCC-Ag and NSE to raise detecting rate and help to identify the type.The results manifest that the detection rate of Pro-GRP is the highest among Pro-GRP,NSE,SCC-Ag,CEA(60.0%>57.8%> 47.8%>37.8%). The association test of Pro- GRP and NSE to dectect small cell lung cancer can raise the detection rate at 93.3%; The association test of CEA and SCC-Ag to dectect lung LSC can raise the detection rate at 83.33%; and the association test of CEA and Pro-GRP to dectect lung ACL can raise the detection rate at 90.0%.Conclusion: 1. Pro-GRP is a better TM than the other for lung cancer. That the serum content of Pro-GRP is 23.19ng/ml can be act as threshold value to differentiate whether it is lung cancer or not ; 2. Pro-GRP makes more sense in SCLC. That the serum content of Pro-GRP is 23.50ng/ml can act as threshold value to differentiate whether it is SCLC or not. 3. The serum level and the positive rate of Pro-GRP are rising along with the aggravating stage of TNM. 4. the more reasonable combined test are as follows:Pro-GRP+NSE for SCLC, CEA+SCC-Ag for LSC, CEA+ Pro-GRP for ACLThe new ideas of the study1. Pro-GRP detection take an important part in lung cancer identification according to the threshold value made by ROC curve.2 . Pro-GRP detection take an important part in SCLC identification according to the threshold value made by ROC curve.3. The positive rate of Pro-GRP is rising along with the aggravating stage of TNM,which would make important sense in the clinical therapy and detecting recur of lung cancer.4. The more reasonable combined test are as follows: Pro- GRP+NSE for SCLC, CEA+SCC-Ag for LSC, CEA+Pro-GRP for ACL.