【摘要】 目的 探讨基于CT征象联合血清标志物在纵隔精原细胞瘤和淋巴瘤鉴别诊断中的价值。方法 回顾性分析2016年1月至2024年5月在郑州大学第一附属医院经病理确诊的15例纵隔精原细胞瘤和50例纵隔淋巴瘤患者的临床资料和CT图像，分析其CT征象及血清标志物差异。结果 15例纵隔精原细胞瘤患者中血清人绒毛膜促性腺激素(β-HCG)升高3例，乳酸脱氢酶(LDH)升高4例，肿瘤最大径为(87.99±33.61)mm,强化值为(27.30±7.02)HU;病变呈实性肿块伴坏死区14例；居中生长7例，淋巴结肿大3例，浆膜腔积液3例。50例纵隔淋巴瘤患者中血清LDH升高32例，肿瘤最大径为(95.25±33.63)mm,强化值为(27.50±7.98)HU;病变呈实性伴坏死区38例，呈纯实性12例；居中生长27例，淋巴结肿大37例，浆膜腔积液34例。两者淋巴结肿大、浆膜腔积液、血清β-HCG升高、血清LDH升高比较，差异有统计学意义(P<0.05)。受试者工作特征曲线分析结果显示：淋巴结肿大的灵敏度为80%,特异度为26%;浆膜腔积液的灵敏度为80%,特异度为32%;血清β-HCG升高的灵敏度为20%,特异度为0%;血清LDH升高的灵敏度为26.7%,特异度为64%。结论 CT征象联合血清标志物对纵隔精原细胞瘤和淋巴瘤的鉴别诊断有一定的价值。更多还原

【Abstract】 Objective To investigate the value of CT features combined with serum biomarkers in the differential diagnosis of mediastinal seminomas and lymphomas. Methods The clinical data and CT images of 15 cases of mediastinal seminoma and 50 cases of mediastinal lymphoma diagnosed by pathology from January 2016 to May 2024 were retrospectively analyzed, and the differences in CT signs and serum markers were analyzed. Results Among the 15 cases of mediastinal seminoma, 3 cases had increased serum human chorionic gonadotropin(β-HCG), 4 cases had increased serum Lactate dehydrogenase(LDH). The maximum diameter of mediastinal seminoma was(87.99±33.61)mm, and the value of enhancement was(27.30±7.02)HU; 14 cases showed solid masses with necrotic areas. Central growth was observed in 7 cases, lymphadenopathy in 3 cases, serosal effusion in 3 cases. Among the 50 cases of mediastinal lymphoma patients, 32 cases had elevated serum LDH levels, the maximum diameter of mediastinal lymphoma was(95.25±33.63)mm, and the value of enhancement was(27.50±7.98) HU; 38 lesions were solid with necrotic areas, 12 lesions were purely solid mass; Central growth was observed in 27 cases, lymphadenopathy in 37 cases, serosal effusion in 34 cases. There were significant differences in the differentiation of mediastinal seminomas and lymphomas by lymphadenopathy, serosal effusion, elevated serum β-HCG, and elevated serum LDH(P<0.05). The ROC curve analysis results showed that the sensitivity and specificity of lymphadenopathy were 80% and 26%, respectively; the sensitivity of serosal effusion was 80%, and the specificity was 32%; the sensitivity and specificity of serum β-HCG elevation were 20% and 0%, respectively; the sensitivity and specificity of elevated serum LDH were 26.7% and 64%, respectively. Conclusions The combination of CT features and serum biomarkers has certain value in the differential diagnosis of mediastinal seminomas and lymphomas.更多还原