【作者】 胡涛；

【导师】 严华；

【作者基本信息】 华中科技大学 ， 外科学， 2011， 硕士

【摘要】 目的:探讨胸部肿瘤标记物与CT对非小细胞肺癌N2病变的诊断意义。方法:选取2010年1月至2010年12月同济医院普胸外科非小细胞肺癌的病人206例,回顾性对照分析其病理类型,N分期与肿瘤标记物(CEA,CYFRA21-1,NSE)以及CT表现的对应关系。结果:肿瘤标记物中,CEA对腺癌纵隔淋巴结转移的对应性较高,CYFRA21-1对鳞癌纵隔淋巴结也有一定的预测作用,NSE无明显作用。CT扫描对非小细胞肺癌纵隔淋巴结转移灵敏度为66.3%,特异度为80.5%。结论:胸部CT扫描对于纵隔淋巴结转移的诊断有一定的提示作用,其灵敏度和特异度仍较低,需其他技术手段补充。肿瘤标志物CEA及CYFRA21-1对NSCLC的N2病变的诊断具有补充作用。更多还原

【Abstract】 ObjectiveThe purpose of this study was to verify the significance of tumor markers and chest computed tomography (CT) as indicators for diagnosis of the N2 mediastinal lymph node metastasis in non-small cell lung cancer.MethodsFrom Jan 2010 to Dec 2010, 206 patients with lung tumor lesion underwent surgical resection at the Department of Thoracic Surgery in Tongji Hospital. The correlation among their pathological types, N staging, tumor markers (CEA, CYFRA21-1, NSE) and CT was prospectively analyzed. Univariate and multivariate analyses were performed to determine the relationship between both marker levels and CT and N2 disease.ResultsIn multivariate analysis, positive CEA was obviously associated with the diagnosis of N2 disease in lung adenocarcinoma. We also demonstrated that when CYFRA21-1 was positive, it was significantly associated with N2 disease in lung squamous cell carcinoma. However, NSE was not associated with N2 disease distinctly. In univariate analysis, sensitivity and specificity were 66.3% and 80.7% for CT scans.ConclusionCT scan in N2 mediastinal lymph node metastasis has higher prognostic action. If the instant cannot diagnose N2 mediastinal lymph node metastasis, it was a kind of virtual supplements that serum CEA and CYFRA21-1.更多还原