【摘要】 目的 探讨64排螺旋CT联合血清肿瘤标记物早期诊断肺癌的价值。方法 回顾性分析本院2018年2月至2019年12月通过病理诊断或介入穿刺检查确诊为肺癌的患者80例以及肺部良性病变患者40例,分别通过64排螺旋CT扫描,检测肿瘤标志物[癌胚抗原(CEA)、胃泌素释放肽前体(ProGRP)、细胞角蛋白片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)]血清水平,并以病理结果作为“金标准”,分析CT联合肿瘤标记物对肺癌的诊断价值。结果 肺癌组“分叶”征、胸膜“凹陷”征、“毛刺”征、支气管“充气”征、“空泡”征、磨玻璃结节比例高于良性病变组(P<0.05);64排螺旋CT诊断共有阳性病例77例,阴性43例,其中16例病理诊断为肺癌的患者漏诊为良性病变,13例病理诊断为良性病变的患者误诊为肺癌;肺癌组血清肿瘤标志物含量高于良性病变组,CEA、NSE、ProGRP、CYFRA21-1阳性率分别为52.50%、76.25%、38.75%、77.5 0%高于良性病变组17.50%、30.00%、10.00%、35.00%(P<0.05);64排螺旋CT联合血清肿瘤标记物早期诊断肺癌敏感度、特异度、准确度、阳性预测值、阴性预测值分别为97.50%、62.50%、85.83%、83.87%、92.59%,其敏感度、准确度高于单独CT诊断80.00%、75.83%,高于单纯四种肿瘤标志物联合诊断灵敏度78.75%、准确度74.17%(P<0.05)。结论 血清肿瘤标志物联合CT相较于单纯CT诊断可进一步提高诊断敏感度和准确度。更多还原

【Abstract】 Objective To explore the value of 64-slice spiral CT(64 SCT) combined with serum tumor markers in the early diagnosis of lung cancer.Methods A total of 80 patients with lung cancer and 40 patients with benign lung lesions who were confirmed by pathological diagnosis or interventional puncture in the hospital from February 2018 to December 2019 were retrospectively analyzed.All underwent64 SCT scans to detect levels of serum tumor markers [precu rsor of gastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin fragment antigen 21-1(CYFRA21-1)].Taking pathological results as the golden standard,the value of 64 SCT combined with serum tumor markers for early diagnosis of lung cancer was analyzed.Results In terms of CT signs,proportions of lobulation sign,spiculation sign,pleural depression,vocule sign,air bronchogram and ground-glass nodule in lung cancer group were higher than those in benign lesion group(P<0.05).64 SCT diagnosis showed that there were 77 positive cases and 43 negative cases.There were 16 cases pathologically diagnosed with lung cancer miss the diagnosis as benign lesions,and 13 cases pathologically diagnosed with benign lesions misdiagnosed as lung cancer.The contents of serum tumor markers in lung cancer group were higher than those in benign lesion group.The positive rates of CEA,NSE,ProGRP and CYFRA21-1 in lung cancer group were 52.50%,76.25%,38.75% and 77.50%,which were higher than those in benign lesion group(17.50%,30.00%,10.00%,35.00%)(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of 64 SCT combined with serum tumors markers for early diagnosis of lung cancer were 97.50%,62.50%;85.83%,83.87% and 92.59%,respectively.And the sensitivity and accuracy were higher than that of CT alone(80.00 %,75.83%),which were higher than those of the four tumor markers(78.75%,74.17%)(P<0.05).Conclusion The combination application of serum tumor markers and CT scan in the diagnosis of lung ca ncer can further improve the sensitivity and accuracy of lung cancer diagnosis.更多还原