Drivsholm L, Paloheimo L I, Osterlind K
Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
Br J Cancer. 1999 Oct;81(4):667-71. doi: 10.1038/sj.bjc.6690745.
Chromogranin A (CgA) is a protein present in neuroendocrine vesicles. Small cell lung cancer (SCLC) is considered a neuroendocrine tumour. It is possible to demonstrate CgA expression in SCLC by immunohistochemical methods. Since CgA is released to the circulation it might also work as a clinical tumour marker. We used a newly developed two-site enzyme-linked immunosorbent assay for CgA in plasma from 150 newly diagnosed patients with SCLC. Follow-up was for a minimum of 5 years. Thirty-seven per cent of the patients had elevated pretreatment values and the values were significantly related to stage of disease. Multivariable analysis by Cox's proportional hazard model including nine known prognostic factors disclosed performance status as the most influential prognostic factor followed by stage of disease, CgA and LDH. A simple prognostic index (PI) could be established based on these four pretreatment features. In this way the patients could be separated into three groups with significant different prognosis. The median survival and 95% confidence intervals for the three groups were as follows: 424 days (311-537), 360 days (261-459) and 174 days (105-243).
嗜铬粒蛋白A（CgA）是一种存在于神经内分泌囊泡中的蛋白质。小细胞肺癌（SCLC）被认为是一种神经内分泌肿瘤。通过免疫组织化学方法可以在SCLC中检测到CgA的表达。由于CgA会释放到循环系统中，它也可能作为一种临床肿瘤标志物。我们使用一种新开发的双位点酶联免疫吸附测定法检测了150例新诊断的SCLC患者血浆中的CgA。随访时间至少为5年。37%的患者治疗前CgA值升高，且这些值与疾病分期显著相关。通过Cox比例风险模型进行的多变量分析纳入了9个已知的预后因素，结果显示体能状态是最具影响力的预后因素，其次是疾病分期、CgA和乳酸脱氢酶（LDH）。基于这四个治疗前特征可以建立一个简单的预后指数（PI）。通过这种方式，患者可以被分为三组，其预后有显著差异。三组的中位生存期及95%置信区间如下：424天（311 - 537天）、360天（261 - 459天）和174天（105 - 243天）。
