The Clinical Significance Of Serum NSE And Pro-GRP Level Changes In The Treatment Of Patients With Small Cell Lung Cancer

Objective:Small cell lung cancer(SCLC)is the most malignant pathological type in lung cancer,with early metastasis,easy recurrence and poor prognosis.To investigate the clinical significance of tumor marker neuron specific enolase(NSE)and gastrin-releasing peptide precursor(Pro-GRP)in SCLC,our study retrospectively analyzed 103 patients with SCLC admitted to our department of respiratory medicine.Through this real event,the role of NSE and Pro-GRP in SCLC is considered to be helpful to clinicians and patients in some extent.Methods:The respiratory department in our hospital was admitted and confirmed as the initial treatment of 103 patients with small cell lung cancer by pathologist during July 2015 to July 2016.The chemotherapy regimen was a combination of platinum-based plus etoposide.All patients were collected the tumor marker,such as NSE and Pro-GRP,by venous blood before the treatment.The ULN(upper limit of normal)of NSE is 20ug/L,and the Pro-GRP is 70pg/ml.After every two cycles of treatment,the efficacy was comprehensively evaluated by imaging examination in terms of Response Evaluation Criteria in Solid Tumors,which can be divided into complete remission,partial remission,stabilization and progress.The effects of NSE and Pro-GRP before the first chemotherapy and before the third chemotherapy were evaluated to evaluate the efficacy of SCLC after 4 cycles of treatment.The survival status of patients was reviewed and followed by telephone,outpatient and case.The primary end point of this research is Progression-free survival,which is from the treatment for the first time to progression or the last follow-up time in months.Finally,software SPSS 21.0 was used for data analysis,and P<0.05 was considered to be statistically significant.Result:Among the 103 patients with SCLC,the age of onset was<65 years accounts for 74.8%,males(85.4%)was the majority,and the percent of smoking index ?400years was 71.8%,and the patients in ED(64.1%)at the time of initial treatment were more than LD(35.9%).There were significant differences in NSE and Pro-GRP levels before and afterchemotherapy.There was a statistically significant difference between Pro-GRP levels and efficacy after 2 cycles of chemotherapy(P=0.001),and the serum Pro-GRP concentrations in the ineffective group after treatment were significantly higher than the effective group.Compared with the NSE,there was a significant difference in the distribution of the patients with the Pro-GRP concentration after chemotherapy between the group of <ULN(upper limits of normal)and that of ?ULN exist statistically difference(P=0.01),and the patients with the level of Pro-GRP in the normal range is more effective in patients with elevated Pro-GRP levels after undergoing chemotherapy.There was no significant difference in NSE level after chemotherapy between age and sex,PS score,stage,but Pro-GRP levels after 2 cycles of therapy,staging and the status of metastasis there is a statistically significant difference,suggesting that the level of Pro-GRP decreased after therapy is lower in the patients with higher staging or metastasis.Univariate analysis found that the serum level of NSE(P=0.001)or Pro-GRP(P=0.019)after chemotherapy and stage(P=0.032)had obvious statistical significance on the PFS,but the age,smoking,PS score,gender and the level of the NSE and Pro-GRP before chemotherapy is not in the list.In the multivariate cox regression analysis,it was found that the level of NSE after chemotherapy and stage were valuable prognostic factors.After chemotherapy,the level of NSE?ULN and ED may prompt shorter PFS.Conclusion:1.In the patients with newly diagnosed SCLC undergoing chemotherapy with platinum and etoposide,the levels of NSE and Pro-GRP before the third chemotherapy have a good indication of the efficacy of chemotherapy in SCLC patients.The curative effect of the Pro-GRP and NSE concentration that after chemotherapy still maintain a high-level may not perfect.2.The level of NSE before the third chemotherapy in initially treated patients with SCLC may serve as an effective risk factor for the prognosis of SCLC patients.Increased NSE levels after chemotherapy may indicate rapid disease progression and poor prognosis.