The Clinical Value Of Gastrin-releasing Peptide Precursors And Neuron-specific Enolase In The Diagnosis And Treatment Of Small Cell Lung Cancer

Objective:This study analyzed the data of lung cancer patients diagnosed and treated in the respiratory department of yijishan hospital of wannan medical college,and discussed the role of neuron-specific enolase(NSE)and progastrin releasing peptide(ProGRP)in the pre-treatment stage,efficacy evaluation and recurrence prediction of small cell lung cancer(SCLC).Methods: Medical records of 50 newly diagnosed SCLC patients treated in wuhu yijishan hospital from January 2018 to September 2019 were collected.During the same period,50 newly diagnosed non-small cell lung cancer(NSCLC)patients were selected as the control group.All patients with lung cancer were histologically and cytologically confirmed as primary lung cancer,and the patients or their families signed the informed consent,aged > 18 years.Exclusion criteria: the patient has received treatment(chemotherapy,radiotherapy,targeted therapy,immunotherapy,etc.);Incomplete clinical data to evaluate subjects;Pregnant or lactating women,aged < 18;Patients with tumors in other parts,serious diseases of heart,liver,kidney and other important organs;History of mental illness or severe brain disease.The age,sex,smoking history,liver and kidney function,tumor stage,and the ProGRP,NSE values,imaging and ultrasound data of the two groups of patients before and after chemotherapy and 3 cycles of chemotherapy(that is,2 weeks after the second cycle)were recorded.The SCLC group continued to monitor basic data such as ProGRP,NSE,imaging and ultrasound before 5 cycles of chemotherapy(2 weeks after the 4th cycle).SPSS 22.0 software and MEDCALE software were used for statistical analysis of all the data.The measurement data conforming to normal distribution were expressed as(x±s),while the measurement data non-normal distribution was expressed as median.Anova was used for measurement data conforming to normal distribution,mann-whitney U test was used for comparison between the two groups,and paired Wilcoxo Sign rank sum test was used for comparison before and after.ROC curve was drawn to evaluate the diagnostic value of ProGRP and NSE for SCLC.The chi-square test was used for rate comparison.The correlation of NSE and pro-grp levels before and after chemotherapy was rank correlation.P < 0.05 was considered statistically significant.Results:SCLC included 41 males and 9 females,aged 34-90(65.08±11.42)years,including 35 smoking patients,17 in the restricted group and 33 in the extensive group,all receiving EP chemotherapy.The NSCLC group included 40 males and 10 females,aged 29-82(66.36±10.86)years,including 25 cases of lung squamous cell carcinoma and 25 cases of lung adenocarcinoma,including 32 cases of smoking patients,who underwent GP chemotherapy for lung squamous cell carcinoma and AP chemotherapy for lung adenocarcinoma.There was no significant difference in gender,age,smoking history and other general data between the two groups(P >0.05).The level of ProGRP and NSE in SCLC group and NSCLC group was statistically different by mann-whitney U test(P < 0.05).In the SCLC group,there were no significant differences in ProGRP and NSE levels among patients of different ages,genders and smoking(P >,0.05).The level of ProGRP and NSE in the extensive period was significantly higher than that in the period,and had statistical significance(P < 0.05).ROC curve of SCLC diagnosis with serum p and NSE was drawn with NSCLC group as control.The area under ROC curve of expression of ProGRP and NSE in SCLC group was 0.935(95%CI:0.867-0.975)and 0.823(95%CI:For comparison,Z was 2.614(P=0.009).For the combined diagnosis of ProGRP and NSE,the area under the ROC curve was 0.942(95%CI: 0.877-0.979).After monitoring the efficacy of chemotherapy in SCLC patients,the levels of NSE and ProGRP in CR+PR+SD patients decreased after chemotherapy,with statistically significant differences(P<0.05).There was no statistically significant difference in NSE level between PD patients before and after chemotherapy(P>0.05),but it was significantly higher after chemotherapeutic treatment(P<0.05).Spearman correlation analysis was performed on serum ProGRP and NSE levels before and after 2cycles of chemotherapy,respectively.The correlation coefficients of P and NSE concentrations before chemotherapy r=0.463,P=0.001,and r=0.754,P=0.000 after 2cycles of chemotherapy.Conclusion: 1.The levels of serum ProGRP and NSE were correlated with the classification and staging of lung cancer,but not with smoking history,gender,age,etc.;The sensitivity and specificity of serum ProGRP and NSE in the diagnosis of SCLC were higher than that of NSCLC.The ProGRP level was better than NSE in the diagnosis of SCLC.The specificity is higher in combination diagnosis.2.The serum ProGRP and NSE levels may be used as indicators for determining the efficacy of SCLC patients.There was a positive correlation between the concentration of serum ProGRP and NSE before and after chemotherapy.