| Objective: The purpose of this study was to explore the value of serum NSE and Pro GRP levels in the auxiliary diagnosis and disease staging of SCLC patients first diagnosed in Yunnan Cancer Hospital.The value of efficacy monitoring,disease recurrence and prognosis prediction,providing clinical data reference.Methods: This study included 1150 patients with small cell lung cancer(SCLC)who were first diagnosed in Yunnan Cancer Hospital from January 1,2018 to October31,2021 and were pathologically diagnosed.In the same period,2244 patients with non-small cell lung cancer(NSCLC),6254 patients with other types of cancer except lung cancer and 2455 healthy people underwent serum NSE and/or Pro GRP assay were included as the control group.The research methods of this study include:1.The serum concentrations of NSE and Pro GRP were analyzed and compared in the four groups of different patients,and the diagnostic efficiency of the single and combined detection was calculated by the ROC curve.A diagnostic cut-off value more suitable for SCLC patients in Yunnan province was obtained.2.To compare the differences in serum NSE and Pro GRP levels between patients with limited disease(LD)and extensive disease(ED)in SCLC,calculate the diagnostic efficacy of individual and combined tests,and obtain the cut-off value for staging.3.Serum NSE and Pro GRP values of 766 patients with SCLC who were evaluated as progression(336 cases)and remission(430 cases)after first-line treatment(1 cycle,2 cycle,3 cycle)were analyzed to explore the efficacy potential of NSE and Pro GRP levels in SCLC.4.The dynamic changes of serum NSE and Pro GRP levels in 68 patients with SCLC were evaluated before and after relapse(2 cycles of chemotherapy),to explore the changing trend of NSE and Pro GRP levels before and after relapse of SCLC.5.Serum NSE and Pro GRP values were compared in 161 patients with good prognosis(> 200 days)and 151 patients with poor prognosis(≤200 days)with SCLC at the first diagnosis,and cut-off values were obtained for prognosis prediction.6.In this study,6 patients with lung adenocarcinoma diagnosed with EGFR driver mutation by previous pathology were confirmed to be transformed into small cell lung cancer by pathological biopsy after TKI treatment.The NSE and Pro GRP values of these patients before and after transformation were enumerated.7.The general information and clinical characteristics of small cell lung cancer patients from 2012 to 2017 were compared with those collected by the research group.Results: This study found that:1.The expression levels of NSE and Pro GRP in SCLC patients were significantly higher than those in NSCLC patients,patients with other types of cancer except lung cancer and healthy people(P < 0.0001).2.As a single serum marker,the sensitivity and specificity of NSE in the diagnosis of SCLC was higher than that of Pro GRP(P < 0.0001).However,the area under the ROC curve was higher than that of Pro GRP in combination with NSE(P <0.0001).3.According to ROC curve,the most suitable NSE cut-off value for the diagnosis of SCLC patients in Yunnan province was ≥23.26μg/L,and the optimal Pro GRP cut-off value was ≥124.5pg/ml.4.Before treatment,the NSE and Pro GRP values of ED patients were significantly higher than those of LD patients(P < 0.05).According to ROC curve,the most suitable NSE cut-off value for staging of SCLC patients in Yunnan province was ≥42.91μg/L,and the optimal Pro GRP cut-off value was ≥105.5pg/ml.5.There was no significant difference in NSE and Pro GRP in the patients evaluated as progression or remission after treatment.The decrease of NSE and Pro GRP in patients evaluated for remission was greater than that in patients evaluated for remission(P < 0.001).6.The level of NSE in patients with SCLC relapse was higher than that in patients without relapse(P < 0.0001),and Pro GRP level was not significantly increased(P > 0.05).7.Age,Xuanwei Fuyuan area or not,smoking,veterans staging,Pro GRP value at first diagnosis,treatment or not,and NSE value after treatment had significant effects on the prognosis of patients with small cell lung cancer(P < 0.05).8.The level of NSE in the first diagnosis of patients with poor prognosis was higher than that of those with good prognosis(P < 0.0001),and there was no significant difference in Pro GRP level increase(P > 0.05).According to ROC curve,the most suitable NSE cut-off value for prognosis of SCLC patients in Yunnan province was ≥36.4μg/L.Conclusions:Serum markers NSE and Pro GRP values are valuable in assisting the diagnosis,preliminary staging and efficacy monitoring of small cell lung cancer.NSE values have the potential to predict the recurrence risk and prognosis. |
