Complementary roles of pro-gastrin-releasing peptide (ProGRP) and neuron specific enolase (NSE) in diagnosis and prognosis of small-cell lung cancer (SCLC)

In this study, we evaluated the clinical usefulness of ProGRP and NSE for d iagnosis and prognosis of small-cell lung cancer (SCLC). Serum levels of Pr oGRP and NSE were determined in 108 healthy subjects, 103 patients with ben ign pulmonary diseases, 142 with non-small cell lung cancer (NSCLC), and 11 4 with SCLC. Sensitivity of ProGRP in diagnosis of SCLC was significantly h igher than that of NSE (64.9 vs. 43.0%, P < 0.001). The difference was subs tantial in patients with limited disease (56.5 vs. 20.3%, P < 0.001). Howev er, 11 of 40 SCLC patients with normal levels of serum ProGRP (27.5%) showe d elevated levels of serum NSE. In the SCLC patients receiving chemotherapy , the CR rate in patients with elevated NSE levels was significantly lower than in patients with normal levels of NSE (18.5 vs. 61.7%, P < 0.001). Ele vation of both ProGRP and NSE was a poor prognostic factor, and patients wi th elevated levels of either ProGRP or NSE showed shorter survival than tho se without. From multivariate analysis, NSE was found to have a greater eff ect on survival of SCLC patients than ProGRP. These findings indicate that ProGRP is more sensitive than NSE for diagnosis of SCLC, while NSE is super ior to ProGRP as a prognostic factor. In conclusion, both ProGRP and NSE an useful tumor markers and they have a complementary role for each other in diagnosis and prognosis of SCLC. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.