Stieber P, Dienemann H, Schalhorn A, Schmitt U M, Reinmiedl J, Hofmann K, Yamaguchi K
Institute of Clinical Chemistry, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Germany.
Anticancer Res. 1999 Jul-Aug;19(4A):2673-8.
Gastrin-releasing-peptide (GRP), the mammalian counterpart of amphibian bombesin, has been reported to be produced by cells of SCLC. Using recombinant ProGRP Yamaguchi et al developed an enzyme immunoassay for the measurement of this more stable precursor of GRP. We focused our interest on the comparability of ProGRP to neuron specific enolase (NSE), CYFRA 21-1 and CEA. For this purpose we investigated the sera of 272 patients with histologically proven carcinomas of the lung (87 SCLC, 185 NSCLC). The sera of 74 patients with benign diseases of the lung and smokers served as a reference group. At a specificity of 95% ProGRP and NSE possessed comparable sensitivities (47% versus 45%) in small cell lung carcinomas. ProGRP showed only a few more positive test results than NSE, but reached much higher value levels than NSE. ProGRP and NSE showed a clear additive sensitivity of about 20%. In NSCLC CYFRA 21-1 was the leading marker with 63% sensitivity, whereas ProGRP seldom showed a "false positive" test result. ProGRP proved a very high specificity and good sensitivity for small cell lung carcinomas and therefore enables diagnosis of small cell lung carcinoma in patients with lung tumours of unknown origin as well as good control of efficiency of therapy.
胃泌素释放肽（GRP）是两栖类蛙皮素在哺乳动物中的对应物，据报道由小细胞肺癌（SCLC）细胞产生。Yamaguchi等人利用重组ProGRP开发了一种酶免疫测定法，用于检测这种更稳定的GRP前体。我们将兴趣集中在ProGRP与神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA 21-1）和癌胚抗原（CEA）的可比性上。为此，我们调查了272例经组织学证实的肺癌患者（87例SCLC，185例非小细胞肺癌（NSCLC））的血清。74例患有肺部良性疾病的患者和吸烟者的血清作为参照组。在小细胞肺癌中，当特异性为95%时，ProGRP和NSE具有相当的敏感性（分别为47%和45%）。ProGRP仅比NSE多几个阳性检测结果，但达到的数值水平比NSE高得多。ProGRP和NSE显示出约20%的明显相加敏感性。在NSCLC中，CYFRA 21-1是主要标志物，敏感性为63%，而ProGRP很少出现“假阳性”检测结果。ProGRP对小细胞肺癌显示出非常高的特异性和良好的敏感性，因此能够诊断不明来源肺部肿瘤患者中的小细胞肺癌，并能很好地监测治疗效果。
