Abstract
Background: One of the most prevalent malignant tumors in China is primary lung cancer. This condition can be broadly categorized into two types: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLC is a type of neuroendocrine tumor highly malignant, undifferentiated, and prone to metastasis. In its early stages, SCLC typically does not present with noticeable symptoms. It is usually diagnosed when the disease has progressed to the middle or late stage. Therefore, early diagnosis is pivotal for enhancing the outcome of SCLC. Pro-Gastrin-releasing peptide precursor (ProGRP) and neuron-specific enolase (NSE) are tumor markers recommended by guidelines for SCLC. This study investigates the diagnostic value and efficacy of ProGRP and NSE serum levels in the context of SCLC, with the intention of providing more valuable references for SCLC diagnosis.
Objective: The purpose of this research is to probe the diagnostic value and therapeutic efficacy of serum levels of ProGRP and NSE in SCLC, with the aim of enhancing the level of clinical diagnosis.
Methods: A total of 84 SCLC patients who were admitted to our hospital from December 2022 to March 2024 were included in the SCLC group. The NSCLC group consisted of 45 patients diagnosed with NSCLC, while the benign lung disease group consisted of 57 patients diagnosed with non-cancerous lung conditions. Furthermore, the healthy control group comprised 60 healthy individuals. The serum levels of ProGRP and NSE were compared across all four groups. Moreover, the concentrations of ProGRP and NSE were compared between patients diagnosed with limited-stage and extensive-stage SCLC. The sensitivity and specificity of serum ProGRP and NSE levels for diagnosing SCLC were analyzed via ROC curve analysis. The critical value of the ROC curve was adopted as the grouping standard, and the clinical efficacy of different levels of serum ProGRP and NSE in SCLC patients was compared. Finally, the correlation between serum ProGRP and NSE levels and age, gender, smoking history, staging, distant metastasis, and tumor diameter in SCLC patients was evaluated.
Results: The concentrations of serum ProGRP and NSE were observed in different groups. The findings confirmed that the SCLC group exhibited considerably elevated levels of serum ProGRP and NSE in comparison to the healthy control group, benign lung disease group, and NSCLC group, with the variance regarded as substantially significant (P<0.05). ProGRP and NSE values were found to be higher in limited-stage SCLC compared to extensive-stage SCLC, and the difference between the groups held remarkable statistical significance (P<0.05). The ROC curve displayed that the critical value of ProGRP for diagnosing SCLC was 136.49pg/mL, the area under the curve (AUC) was 0.869, the sensitivity attained 80.00%, and the specificity reached 84.87%, indicating a diagnostic efficacy better than that of NSE (P<0.05). Additionally, following two cycles of chemotherapy, the low-level ProGRP group exhibited a superior therapeutic effect compared to the high-level ProGRP group (P<0.05), but the two groups did not manifest remarkable statistical difference in terms of PFS (P>0.05). No statistically meaningful variance was detected in PFS and therapeutic effect between the low-level NSE group and the high-level NSE group (P>0.05). Subsequent to further analysis of the correlation between serum ProGRP and NSE levels and age, gender, smoking history, staging, and so on, it was unraveled that their levels did not significantly correlate with the patient’s age, gender or smoking history (P>0.05) but were evidently associated with staging. ProGRP and NSE levels were discovered to be higher in extensive-stage SCLC when compared to limited-stage SCLC. Moreover, in SCLC patients with lymph node metastasis and a tumor diameter ≥ 5 cm, the serum levels of ProGRP and NSE were higher than in patients without lymph node metastasis and with a tumor diameter < 5 cm, and the difference was considered statistically meaningful (P<0.05).
Conclusion: The levels of tumor markers ProGRP and NSE are of paramount significance for the clinical diagnosis and staging of SCLC patients. ProGRP is a more specific and sensitive tumor marker for SCLC than NSE and can be employed as an auxiliary diagnostic tool for SCLC. Thus, it is worth promoting ProGRP in a clinical setting.
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