【摘要】 目的探讨对存在肺磨玻璃结节的老年患者行外周血肺癌驱动基因检测,对肺磨玻璃结节良恶性诊断的临床价值。方法回顾性分析19例经胸部低剂量螺旋CT检查发现存在肺磨玻璃结节的老年患者,采集外周血,应用二代测序(NGS)技术对外周血进行肺癌驱动基因检测,随后手术切除或穿刺活检磨玻璃结节,经病理学检查明确肺癌诊断。以病理诊断作为诊断金标准,计算肺癌驱动基因检测对肺癌诊断的灵敏度、特异度、假阳性率、假阴性率、诊断符合率。结果 19例肺磨玻璃结节患者中,肺癌驱动基因阳性者10例,手术后病理均符合肺癌;肺癌驱动基因阴性者9例,手术后病理示腺癌3例、鳞癌1例、曲霉菌病1例、炎症或机化4例。肺癌驱动基因检测对存在肺磨玻璃结节患者的肺癌诊断灵敏度为71.4%(10/14),特异度为100%(10/10),假阳性率为0%(0/5),假阴性率为28.6%(4/14),诊断符合率为78.9%(15/19)。结论对存在肺磨玻璃结节的老年患者,进一步采用外周血驱动基因检测能够提高对早期肺癌的临床诊断率。更多还原

【Abstract】 Objective To investigate the clinical diagnostic value of peripheral blood lung cancer driver gene detection in elderly patients with pulmonary ground glass nodules.Methods The retrospective analysis including 19 elderly patients with pulmonary ground glass nodules detected by low-dose spiral CT of chest. Peripheral blood samples were collected,lung cancer driver genes were detected by second-generation sequencing(NGS)technology,and then the ground glass nodules were surgically removed and confirmed by pathological examination. The sensitivity,specificity,false positive rate,false negative rate and diagnostic coincidence rate were calculated,and pathological diagnosis was the gold standard for diagnosis.Results Among the 19 patients with ground glass nodules,10 cases were positive for lung cancer driver gene,and the postoperative pathology was consistent with lung cancer;9 cases were negative for lung cancer driver gene,and postoperative pathology showed 3 cases of adenocarcinoma,1 case of squamous cell carcinoma,1 case of aspergillosis,and 4 cases of inflammation or organization. The sensitivity of lung cancer driver gene in detection of lung cancer in patients with pulmonary ground glass nodule was 71. 4%(10/14),the specificity was 100%(10/10),the false positive rate was 0%(0/5),the false negative rate was 28. 6%(4/14),the diagnostic coincidence rate was 78. 9%(15/19).Conclusion For the elderly patients with ground glass nodules,further detection of peripheral blood driven gene can improve the clinical diagnosis rate of early lung cancer.更多还原