【进展】前胃泌素释放肽：小细胞肺癌一个新的生物标记

                                                                                                                                                                                                                                         前胃泌素释放肽：小细胞肺癌一个新的生物标记
出处：Clin Biochem. 2004 Jul;37(7):505-11.
丁香园检验版kiddy1010战友翻译
ProGRP: a new biomarker for small cell lung cancer.Molina R, Filella X, Augé JM.
Oncobiology Unit Laboratory of Clinical Biochemistry, IDIBAPS, Hospital Clinic, Barcelona 08036, Spain. [e-mail]

Progastrin-releasing peptide (ProGRP) is a recently identified biomarker of small cell lung cancer (SCLC), a disorder of neuroendocrine tissue differentiation. The upper normal limit of ProGRP in the circulation is 50 pg/ml. Impaired glomerular filtration tends to increase circulating levels and confound the tumor marker significance of modestly elevated values. Excluding patients with renal failure, circulating levels did not exceed 80 pg/ml in benign disease (3% of cases in excess of the upper normal limit) or 120 pg/ml in malignancy other than lung cancer and neuroendocrine tumors (5% of cases in excess of the upper limit). ProGRP serum levels are clearly related to the lung cancer histological type with significantly higher levels observed in SCLC than in nonsmall cell lung cancer (NSCLC). Circulating ProGRP in excess of 120 mg/ml was found in only 4% of cases of NSCLC with another 22% presenting with modestly elevated levels in excess of the upper normal limit. By contrast, abnormal ProGRP results are found in 60-70% and in 75-90% of SCLC patients with local and extensive disease, respectively. ProGRP is a more sensitive biomarker than is neuron-specific enolase (NSE) for SCLC, but thus far has not been found in multivariate analysis to have independent prognostic significance. Preliminary studies suggest ProGRP will have utility in conjunction with NSE in monitoring the therapy of established SCLC.

前胃液素肽（ProGRP）是最近发现的小细胞肺癌（SCLC）的生物标志物，它是神经内分泌组织异常分化所导致。外周循环中ProGRP的正常上限为50pg/ml。肾小球滤过损伤会使外周循环中的量增加，所以作为肿瘤标志物，应该适当增加上限。除了肾衰竭病人，一般良性疾病时不会超过80 pg/ml（3%的病人会超过这个上限），与肺癌和神经内分泌肿瘤不同，肾部恶性疾病一般不会超过120 pg/ml（5%的病人会超过这个上限）。血清ProGRP水平与肺癌的病理类型有着很清楚的关系，小细胞肺癌（SCLC）比非小细胞肺癌（NSCLC）具有更高的水平。在NSCLC患者中，循环ProGRP仅有4%超过120pg/ml，另外有22%的患者轻微超过正常上限。然而，在SCLC患者中，分别有60-70%的局限性肺癌和75-90%广泛性肺癌中出现异常的ProGRP增高。作为SCLC的肿瘤标志物，ProGRP比神经元特异性烯醇酶（NSE）具有更高的敏感性，但是目前通过方差分析，ProGRP对肺癌的预后并不是独立因素。初步的实验提示ProGRP可以结合NSE对确定的SCLC治疗过程中达到监测作用。