摘要
目的探讨血浆嗜铬粒蛋白A（CgA）对神经内分泌肿瘤的诊断价值，同时评价血浆CgA对胃肠胰腺内分泌肿瘤的诊断效力，初步探讨血浆CgA对胃肠胰腺内分泌肿瘤预后的监测作用。方法应用酶联免疫试剂盒检测56例胃肠胰腺内分泌肿瘤、52例嗜铬细胞瘤和7例小细胞肺癌的血浆CgA浓度，同时以52例健康体检者作为对照，计算血浆cgA诊断胃肠胰腺内分泌肿瘤、嗜铬细胞瘤和小细胞肺癌的敏感性和特异性。56例胃肠胰腺内分泌肿瘤包括类癌13例，胃泌素瘤13例，胰岛细胞瘤12例以及18例其他类型神经内分泌肿瘤，比较血浆cgA在不同胃肠胰腺神经内分泌肿瘤的浓度差异，并计算其对胃肠胰腺神经内分泌肿瘤诊断的敏感性。同时评价血浆CgA对胃肠胰腺神经内分泌肿瘤非转移与转移病例的诊断价值。结果胃肠胰腺内分泌肿瘤组的血浆cgA浓度[中位数（上，下四分位数）]为84．5（38．3，175．5）U／L，嗜铬细胞瘤组为154．0（53．3，243．8）U／L，小细胞肺癌组为55．0（19．0，79．0）U／L，显著高于正常对照组的18．5（12．3，25．8）U／L，P〈0．001。血浆CgA诊断胃肠胰腺内分泌肿瘤、嗜铬细胞瘤和小细胞肺癌的敏感性分别为82．1％、88．5％和57．1％，特异性均为96．2％。在胃肠胰腺内分泌肿瘤中，胃泌素瘤组的血浆CgA浓度显著高于类癌组、胰岛细胞瘤组和其他胃肠胰腺神经内分泌肿瘤组；血浆cgA诊断胃泌素瘤、类癌和胰岛细胞瘤的敏感性分别为92．3％、84．6％和50．O％。胃肠胰腺神经内分泌肿瘤组中，发生转移者的血浆CgA浓度显著高于非转移者。结论血浆CgA在胃肠胰腺神经内分泌肿瘤中的水平显著升高，尤其是诊断胃泌素瘤具有相当高的敏感性，同时也可作为监测肿瘤发展和评价预后的指标。
Objective To investigate the value of plasma chromogranin A （CgA） in the diagnosis of neuroendoerine tumors （NETs）, and to evaluate the diagnostic efficacy of plasma CgA in different gastrointestinal pancreatic neuroendocrine tumors （GEP NETs）. To investigate the role of monitoring plasma CgA in the progress of GEP NETs. Methods ELISA kits were used to measure the CgA plasma level in 56 cases of GEP NETs, 52 cases of pheochromocytoma, and 7 cases of small cell lung cancer （SCLC） and 52 eases of normal controls respectively. The sensitivity and specificity of plasma CgA in diagnosis of gastrointestinal pancreatic endocrine tumor; pheoehromocytomas and SCLC were calculated. The group of GEP NETs included 13 cases of gastrointestinal carcinoid tumors, 13 cases of gastrinomas, 12 cases of islet cell tumors and 18 cases of other type tumors of GEP NETs. The differences of plasma CgA levels and various sensitivities were compared in different types tumors of GEP NETs. Meanwhile the value of plasma CgA in the diagnosis of metastatic and nonmetastatic tumors in GEP NETs was determined. Results The median CgA levels and quartile of the groups of GEP NETs, pheochromocytomas and SCLCs were 84. 5 U/L and 38.3-175.5 U/L, 154.0 U/L and 53.3-243.8 U/L, and 55.0 U/L and 19. 0-79.0 U/L respectively, which were significantly higher than that of （ 18.5 U/L and 12. 3-25.8 U/L） normal controls
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第2期124-127,共4页
Chinese Journal of Internal Medicine
