According to the Chinese health statistics show that lung cancer is the highest mortality rate of malignant tumors in China, and in recent y
According to the Chinese health statistics show that lung cancer is the highest mortality rate of malignant tumors in China, and in recent years, the incidence of women has gradually increased, with men. Primary lung cancer can be divided into lung squamous cell carcinoma, adenocarcinoma and large cell lung cancer and small cell four tissue types, bronchogenic tumor 20%~25% is small cell lung cancer, the other three types of lung cancer and small cell lung cancer in clinical manifestations and different biological behaviour, called non-small cell lung cancer.
At present, the commonly used serological markers of lung cancer include neuron specific enolase (NSE), gastrin releasing peptide precursor (ProGRP), CYFRA21-1, squamous cell carcinoma antigen (SCC) and so on.
Neuron specific enolase (NSE)
Enolase is the final enzyme that catalyzes the hydrolysis of glycerol in the glycolytic pathway. It encodes 5 different subunits of alpha, beta and gamma by 3 independent gene fragments. Two dimer is the active form of the enzyme molecule, alpha subunit were located in glial cells, called neuron specific enolase (NNE); isozyme gamma subunits exist only in neurons, axons and neuroendocrine cells, called neuron specific enolase and its molecular weight 87kD, PI4.7, NSE concentration in serum of healthy adults < 15ug/L.
Strengthen the tumor cell glycolysis, accelerate cell cycle, the intracellular NSE release into the blood increased, resulting in increased levels of this enzyme in serum, it has been recognized that NSE is sensitive and specific of small cell lung cancer tumor markers can be used to detect the effect of differential diagnosis and in patients with small cell lung cancer, the positive rate can be as high as 65%~100%.
Gastrin releasing peptide precursor (ProGRP)
Gastrin releasing peptide (GRP) is a kind of action of gastrin secretion of ghrelin in 1978 from pig gastric tissues were isolated, ProGRP is a precursor to the structure of GRP, the main expression of the gastrointestinal tract, respiratory tract and central nervous system, has good stability in serum in healthy adults, the concentration of serum ProGRP < 50pg/ml.
ProGRP can be used in the diagnosis, curative effect monitoring and prognosis of small cell lung cancer, the diagnostic sensitivity is 47%~86%, the specificity is close to 100%, and its specificity as a single tumor marker is better than NSE.
CYFRA21-1 is the two soluble keratin CK19 fragment, is a new kind of epithelial tumor marker, is widely distributed in normal tissues such as the surface of bronchial epithelial cells, tumor cell lysis occurs due to be destroyed and released into the blood. Serum CYFRA21-1 concentration in healthy adults < 3.3ug/L.
The diagnostic sensitivity of CYFRA21-1 in different tissues of different types of lung cancer, the positive rate of diagnosis of squamous cell carcinoma, adenocarcinoma and large cell carcinoma were 67%, 46%, 67%, of small cell carcinoma of the lowest sensitivity, is of high value for the diagnosis of non-small cell lung cancer; serum level with tumor stage increased gradually increased, consistent with the the degree of malignancy and metastasis, prognosis of non-small cell lung cancer is an important factor.
Squamous cell carcinoma antigen (SCC)
SCC is a subgroup of 1977 isolated from cervical squamous cell antigen TA-4, the molecular weight of 42~48kD and isoelectric focusing electrophoresis can be divided into neutral and acidic two sub components, of which the acidic components only in malignant cells. Serum SCC concentration in healthy adults was < 1.5 ug/L.
The determination of serum SCC can be used in squamous epithelial tumors such as cervix, esophagus, head and neck, lung, etc.. Squamous cell carcinoma of the lung SCC positive rate of about 60%, and other types of lung cancer, the positive rate of less than 30%; patients with radical surgery, SCC will be negative in 72 hours, and received palliative resection or laparotomy after SCC is still higher than the normal value; postoperative recurrence or metastasis of the tumor, SCC in clinical manifestations appear before you can again increased; no recurrence or metastasis, will continue to stabilize at a normal level.
Target detection of non small cell lung cancer
The non Kyrgyzstan tyrosine kinase inhibitors and erlotinib as the representative of the (TKI) is currently widely used in non small cell lung cancer with small molecular targeted drugs, the drugs targeting EGFR. KRAS gene is an important regulator of EGFR signaling pathway, which has a good predictive value in drug sensitivity. The national comprehensive cancer network (NCCN) "non-small cell lung cancer clinical practice guidelines" clearly pointed out that patients with non-small cell lung cancer should detect the mutations of EGFR gene using Iressa and tarceva.
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