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中央型肺鳞癌、小细胞肺癌CT征象与血清肿瘤标志物的关系及联合诊断的价值*

作者:努尔兰 余莹莹 韩文广 周 永 阿里甫

所属单位:新疆医科大学附属肿瘤医院(新疆 乌鲁木齐 830011)

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摘要

目的探讨中央型肺鳞癌、小细 胞肺癌CT征象与血清肿瘤标志物的关系 及联合诊断的价值。方法 收集54例经 病理证实的中央型肺鳞癌及小细胞肺癌 患者,同时行CT检查及血清肿瘤标志物 CA125、CEA、CYFRA21-1、NSE、ProGRP、 SCC检测,将CT征象及血清肿瘤标志物 进行对照研究。结果 肿块的形态、密 度、强化方式、支气管的形态、阻塞性 征象以及淋巴结融合在肺鳞癌组与小细 胞组之间差异有统计学意义(p<0.05); CYFRA21-1、NSE、proGRP、SCC在鳞癌 组与小细胞肺癌组之间差异有统计学意 义,并且CYFRA21-1、SCC在鳞癌组较小 细胞肺癌组高,而NSE、proGRP在小细胞 肺癌组较高;两者联合检测由于单项检 测;CYFRA21-1与肿瘤的密度以及强化 方式差异与统计学意义(p<0.05);CEA 与淋巴结肿大之间差异有统计学意义(p <0.05)。结论 CT征象与血清肿瘤标志物 联合检测有助于提高肺癌的检出率及诊断 正确率;肺癌的肿块的密度、强化方式与 CYFRA21-1有一定相关性;CEA与淋巴结肿 大有一定相关性。

Objective To study on the correlation of CT features and tumor markers and on the diagnostic value of the combination both in detection for central pulmonary SCLS and squamous carcinoma. Methods 52 cases central pulmonary SCLS and squamous carcinoma confirmed by pathology received CT scan and the test of tumor markers which included CA125、CEA、CYFRA21-1、NSE、ProGRP、SCC.CT features were analysed comparatively with serum tumor markers test. Results There were significance between tumor features,density,enhancement, bronchial truncation,obstructive atelectasis,lymph node metastases(p<0.05).There were difference between CYFRA21- 1,NSE,proGRP,SCC.CYFRA21-1,SCC of squamous carcinoma were higher than SCLC.NSE,proGRP of SCLC were higher than squamous carcinoma.The combination of CT features and test of tumor markers were better than the single one in detecting lung cancer.There were significance between CYFRA21-1 and density and enhancement(p <0.05).There were significance between CEA and lymph node metastases(p<0.05). Conclusion Combination of CT features and tumor markers could improve the accuracy rate in diagnosing lung cancer. Density and enhancement have certain correlation with CYFRA21-1.Lymph node metastases have certain correlation with CEA.

【关键词】肺癌;中央型肺癌;小细胞肺癌;血清肿瘤标志物;CT

【中图分类号】R734.2

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.09.018

前言

目前,肺癌是威胁癌症患者最大的原因,其发病率正呈逐年上升 趋势[1]。肺癌的早期发现、早期诊断、早期治疗正深入人心。随着CT 设备及技术的不断更新,其图像分辨率及后处理技术不断提高,进一 步提高了肺癌的形态学特征显示。伴随着分子生物学的不断发展,血 清肿瘤标志物用于肺癌的诊断、疗效的评估及预后正趋于成熟[2]。但 是多数学者证实仅仅使用一种检查方法对肿瘤的诊断的特异性及灵敏 性较低[3]。本文旨在探讨中央型鳞癌及小细胞肺癌的MSCT联合血清肿 瘤标志物诊断肺癌的价值,及MSCT征象与血清肿瘤标志物的关系。