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Objective:To investigate the correlation of serum pro-gastrin-releasing peptide (ProGRP), sugar chain antigen 242(CA242), procalcitonin(PCT) levels in patients with chronic atrophic gastritis (CAG) with intestinal metaplasia and Helicobacter pylori(Hp) infection and prognosis.Methods:One hundred patients with CAG intestinal metaplasia in Emergency General Hospital were selected as the research objects, and they were divided into infection group (75 cases) and non-infected group (25 cases) according to whether they had Hp infection. The clinical data, levels of serum ProGRP, CA242, and PCT were compared between the two groups, and the diagnostic value of the combination of serum indicators in the diagnosis of Hp infection in CAG intestinal metaplasia patients and their correlation with prognosis were analyzed.Results:The degree of atrophy and intestinal metaplasia in the infected group were higher than those in the non-infected group ( P<0.05). The levels of serum ProGRP, CA242 and PCT in the infected group were higher than those in the non-infected group: (159.41 ± 42.38) ng/L vs. (105.84 ± 18.29) ng/L, (7.24 ± 2.28) kU/L vs. (4.12 ± 1.30) kU/L, (3.84 ± 1.12)μg/L vs. (2.57 ± 0.82) μg/L, there were statistical differences ( P<0.05). The results of Spearman analysis showed that the levels of ProGRP, CA242, PCT had positive correlation with atrophy degree ( r = 0.614, 0.629, 0.672, P<0.05), and had positive correlation with intestinal metaplasia degree ( r = 0.574, 0.591, 0.603, P<0.05). The area under the curve (AUC) for the combined diagnosis of Hp infection in patients with CAG intestinal metaplasia by serum ProGRP, CA242, and PCT was 0.874 (95% CI 0.793 - 0.932), the diagnostic sensitivity and specificity were 76.00% and 92.00%, respectively. The incidence of gastric neoplasms in patients with Hp positive combined diagnosis of serum ProGRP, CA242, and PCT within 2 years (11.86%) was higher than that of negative patients (0), but the difference was not statistically significant ( P>0.05). Conclusions:The levels of serum ProGRP, CA242 and PCT in patients with CAG intestinal metaplasia are closely related to Hp infection. The combination of various indicators has high application value in the diagnosis of Hp infection.
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Pro-gastrin-releasing peptide (ProGRP) is a specific marker of small cell lung cancer.
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Objective To explore the expressions and clinical values of pro-gastrin-releasing peptide(ProGRP) and carbohydrate antigen 72-4 (CA72-4) in patients with gastric cancer.Methods Ninety patients with gastric cancer and fifty healthy subjects were selected from January 2014 to December 2016 in our hospital.Serum levels of ProGRP and CA72-4 were detected by electrochemiluminescence.The relationships between ProGRP and clinicopathological characteristics,postoperative recurrence and CA72-4 were analyzed.The diagnostic values of ProGRP and CA72-4 in gastric cancer were analyzed by receiver operating characteristic (ROC) curve.Results The expressions of ProGRP and CA72-4 in patients with gastric cancer were (249.3 + 28.9) pg/ml and (148.8 + 33.5) U/ml respectively,which were significantly higher than those of healthy subjects [(14.4 ± 7.6) pg/ml and (3.8 ± 1.4) U/ml],and the differences were statistically sigificant (t =56.320,P ＜ 0.001;t =30.504,P ＜ 0.001).The expression of ProGRP in TNM stage Ⅲ-Ⅳ [(269.1 ±30.9)pg/ml] was obviously higher than that in stage Ⅰ-Ⅱ [(198.5 +23.9)pg/ml],with a significant difference (t =11.200,P ＜ 0.001).The expression of ProGRP in patients with lymph node metastasis [(259.9 ±31.4)pg/ml] was significantly higher than that in patients without lymph node metastasis [(190.3 ±26.8)pg/ml],with a significant difference (t =9.500,P ＜ 0.001).The expression of ProGRP in patients with postoperative recurrence after one year [(181.3 ± 21.7)pg/ml] was higer than that in patients without postoperative recurrence [(26.1 ± 12.8)pg/ml],with a significant difference (t =31.830,P ＜ 0.001).There was a positive correlation between serum ProGRP and CA72-4 (r =0.792,P =0.012).According to the ROC curve,the cut-off point of ProGRP was 23.6 pg/ml,and the diagnostic sensitivity was 80.0％,the specificity was 70.0％.The cut-off point of CA72-4 was 11.2 U/ml,and the diagnostic sensitivity was 60.0％,the specificity was 89.0％.The sensitivity and specificity diagnostic value of combined detection were 89.7％ and 94.8％,better than those of individual detection (x2 =6.028,P =0.009;x2 =4.675,P =0.031).Conclusion ProGRP and CA72-4 are highly expressed in the serum of gastric cancer patients,with a positive correlation.The combined detection of ProGRP and CA72-4 can improve the diagnostic sensitivity and specificity.ProGRP is significantly correlated with tumor stage,lymph node metastasis and prognosis,which may be a mew target for prevention and treatment of gastric cancer.
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Objective To explore the clinical significance of serum ProGRP in diagnosis of SCLC.Methods Serum ProGRP were detected in twenty-three SCLC patients,forty NSCLC patients and forty-three patients with benign pulmonary disease whose were definite diagnosis collected from April 15,2016 to July 19,2016,and a contemporary cohort of 40 healthy controls were while recruited.Results The levels of ProGRP in SCLC group were significantly higher than those in NSCLC group,benign pulmonary disease group and healthy control group(P 0.05 ).The boundary value of diagnosis of SCLC through ProGRP identified through ROC curve was 65.66 ng/L.The sensitivity and specificity of the ProGRP for the diagnosis of SCLC were respectively 90.9% and 89.9%.Conclu-sion Serum ProGRP can be use as a sensitive and specific index for diagnosis of SCLC,and the level of ProGRP can also be used for the clinical staging of SCLC.
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Objective The aim of this study was to assess the clinical value of pro-gastrin releasing peptide (ProGRP) , squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and carcino-embryonic antigen (CEA) in the diagnosis and clinical stage of lung cancer in Chinese patients.Methods Patients with lung cancer and benign lesions confirmed by pathology were enrolled in Peking Union Medical College Hospital from January 2013 to October 2014.The serum levels of four tumor markers (ProGRP, SCC-Ag, Cyfra21-1 and CEA) were measured using immunoassays before treatment.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the areas under the receiver operating characteristic curve (AUCROC) of these four tumor biomarkers were analyzed for the diagnosis of lung cancer.Results A total of 134 patients were finally analyzed, including 73 patients with lung cancer and the other 61 patients with benign lung disease.The diagnostic sensitivity of serum Cyfra21-1 to lung cancer was 67.1％, the specificity 45.1％, the AUCROC 0.658.The diagnostic sensitivity of the panel including ProGPR, Cyfra21-1 and CEA to lung cancer was 75.3％ , the specificity 57.4％ , the AUCROC 0.702.In the lung cancer group, the AUCROC of ProGRP over 65 ng/L to diagnose small cell lung cancer was 0.954;the AUCROC of SCC-Ag over 1.5 μg/L to diagnose squamous cell lung cancer was 0.788;the AUCROC of Cyfra21-1 to diagnose non-squamous-non-small-cell lung cancer was 0.716.In small cell lung cancer patients, the level of ProGRP in limited-disease small cell lung cancer (LD-SCLC) were significantly higher than that in extensive-disease small cell lung cancer (ED-SCLC) (P =0.005).Conclusion This panel of serum tumor markers including ProGRP, Cyfra21-1 and CEA improves the diagnostic specificity and sensitivity in patients with high-risk lung cancer.The serum CEA level of advanced lung cancer patients is significantly increased.The high level of serum ProGRP predicts the ED-SCLC.
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Objective The value of pro-gastrin releasing peptide ( PGRP) which is the tumor marker of small cell lung canc-er has become a hot topic in recent years .The research was to build a new enzyme-linked immune sorbent assay ( ELISA) method ai-ming at detecting the concentration of PGRP in patients′serum. Methods We utilized synthetic PGRP epitopes for the screening of the monoclonal antibodies , labeled the screened monoclonal antibodies with horseradish peroxidase by modified sodium iodide method , and then established double antibody sandwich ELISA which could be used to detect the serum concentrations of PGRP in cancer pa -tients. Results We successfully screened E 12 mAb which could be served as the coating antibody and ED 1 mAb as the labeled anti-body.The standard antibody density range of new ELISA was 33 pg/mL~1.7 ×104 pg/mL.The comparison experiments between our method and the commercially available ELISA kit showed no significant difference ( P>0.05).The specificity of our method was 50%, and the sensitivity was 100%, while IBL kit was 92.2% and 100% respectively. Conclusion New ELISA can be used to detect the serum PGRP concentration in patients with small cell lung cancer .
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Objective To study the correlation of the serum levels of pro-gastrin-releasing peptide (ProGRP) and neuro-specific enolase (NSE) with different treatments in limited-disease small cell lung cancer (L-SCLC) patients.Methods 150 L-SCLC patients were randomly divided into three groups including concurrent chemo-radiotherapy group,sequential chemo-radiotherapy group,and chemotherapy group.The serum levels of ProGRP and NSE were detected by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay before and after different treatments.The follow-up phase was 12 months.Results The serum levels of ProGRP and NSE were significantly decreased in all 3 groups after treatment (318.96,250.77,226.18 pg/ml and 31.72,23.95,17.89 μg/L),and the lowest level was observed in concurrent chemo-radiotherapy group,then the sequential chemo-radiotherapy group and chemotherapy group.The short term therapeutic effects were in the same sequence,and there was statistical significance between concurrent chemoradiotherapy group and chemotherapy (P ＜ 0.05).The decrease extent of ProGRP and NSE in effective cases (CR+PR) was significantly higher than that in failure cases in all 3 groups.The serum levels of ProGRP and NSE were increased with disease progress (P ＜ 0.05).Conclusion The serum levels of ProGRP and NSE can be used to reflect the patient' s condition and evaluate therapeutic effect in L-SCLC.The concurrent chemo-radiotherapy is more effective than sequential chemo-radiotherapy and chemotherapy only in L-SCLC.
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To date, most clinical data on pro-gastrin-releasing peptide (proGRP) have been based on serum concentrations. This study evaluated the agreement between proGRP levels in fresh serum and plasma in patients with various lung diseases. Pairs of serum and EDTA plasma were collected from 49 healthy individuals. At the same time, EDTA plasma of 118 lung cancer patients and 23 patients with benign pulmonary diseases were prospectively collected. Compared to serum, plasma proGRP concentrations were higher by an average of 103.3%. Plasma proGRP was higher in malignancy (336.4 +/- 925.4 pg/mL) than in benign conditions (40.1 +/- 11.5 pg/mL). Small cell lung cancer (SCLC) patients showed higher levels of proGRP (1,256.3 +/- 1,605.6 pg/mL) compared to other types of lung cancer. Based on the ROC curve analyses at a specificity of 95%, the diagnostic sensitivity of plasma proGRP was estimated to be 83.8% in distinguishing SCLC from all the other conditions, and 86.5% for discriminating SCLC from the nonmalignant cases. Among the SCLC cases, limited stage disease had lower levels of plasma proGRP than extensive disease. When measuring circulating levels of proGRP, the use of plasma is preferred over serum. Plasma proGRP has a potential marker for discriminating SCLC from nonmalignant conditions or non-small cell lung cancer.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Carcinoma, Non-Small-Cell Lung/blood , Diagnosis, Differential , Lung Diseases/blood , Lung Neoplasms/blood , Peptide Fragments/blood , Recombinant Proteins/blood , Sensitivity and Specificity , Small Cell Lung Carcinoma/blood , Biomarkers, Tumor/bloodABSTRACT
Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ～Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P＜0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P＜0.01 ).The serum level of NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P＜0.01).The positive rate of serum ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P＜0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P＜0.01).The positive rate of serum NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P＜0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ～Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P＜0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ～Ⅱ SCLC group were obviously higher than that in the NSE (P＜0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.
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Objective To evaluate the clinical value and relationship between the serum levels of the Pro-gastrin-releasing peptide 31-98 (ProGRP) , neuron-specific enolase NSE and the different pathohistology types of lung cancer. Methods 353 lung cancer patients were divided into two groups according to pathohistology types: SCLC group( n = 96), NSCLC group( n = 257). 90 lung benign lesion were taken as control group. ProGRP and neu-ron specific enolase in all patients were detected by ELISA. The levels of the ProGRP, NSE and the clinical value were compared among lung cancer,lung benign lesion patients and the different pathohistology types of lung cancer patients . Results The levels of the ProGRP and NSE of SCLC and NSCLC group were higher obviously than that of lung benign lesion( P <0.01 ). In SCLC diagnosis, the sensitivity, specificity, Youden index and Kappa value of the ProGRP and NSE were O. 7708,0. 9444,0. 7153,0.7111 and 0. 7604,0. 8778 ,0. 6382 ,0. 6355 in the monomial de-tection ; Those indexes above were 0.7604,0. 9667,0.7271 and 0. 7221 in combined assay of ProGRP + NSE( on se-quence test) ; and were O. 8229,0.9000,0. 7229 and 0. 7209 in combined assay of ProGRP + NSE( on parallell test). In NSCLC diagnosis,the above indexes were all lower. Conclusions in SCLC diagnosis,the detection of the serum ProGRP is superior to the detection of NSE, the combined assay of ProGRP + NSE (on parallell test) and Pro-GRP + NSE( on sequence test) are superior to the monomial detection of the ProGRP or NSE,and the combined as-say of ProGRP + NSE(on parallell test) is superiro to ProGRP + NSE(on sequence test) ; The diagnosis value of the monomial arid united detection of ProGRP and NSE to NSCLC is not as expected.