目的 探讨增强CT扫描联合肿瘤 标志物检测在诊断肾癌中的临床价值。 方法 选取我院2014年2月-2016年2月期 间收治的经临床手术及病理确诊的肾癌患 者60例为研究对象，均分别行肿瘤标志物 检查、CT和增强CT扫描检查，两种检查方 法独立进行，检查结果进行独立分析。比 较不同检查方法病理分型、分期准确性， 并分析肾癌患者CT扫描影像学表现。结果 肿瘤标志物检查在病理分期方面准确率均 高于CT扫描检查，而CT扫描在检查病理分 型准确率均高于肿瘤标志物检查。CT扫描 影像学表现为21例腹膜后淋巴结转移，肝 脏转移，增强扫描肾病症呈明显强化改 变；17例肾下极局部轮廓外突，可见异常 密度影，增强后皮髓交界期可见病灶明显 强化，实质期呈等密度；12例肾轮廓明显 增大，可见低密度灶，边界清晰，密度不 均匀，增强后病灶无明显强化；10例伴 肝、后腹膜转移，肾见软组织团块，增强 扫描后病灶明显强化。结论 CT和增强CT 扫描影像学具有明显的特征性，增强CT扫 描、肿瘤标志物检查在肾癌病理分型和病 理分期方面准确性各有优势，二者联合检 测对诊断肾癌具有重要的临床价值。

Objective To explore clinical value of enhanced CT scanning combined with detection of tumor markers in the diagnosis of renal carcinoma. Methods 60 patients with renal carcinoma confirmedbyclinical operation and pathology treated in our hospital from February 2014 to February 2015 were selected as the research objects, they underwent tumor markers examination, CT and enhanced CT scanning respectively, two examination methods were independently performed, examination results were analyzed independently. Pathological type, staging accuracy of different examination methods were compared, CT scan imaging performance of patients with renal carcinoma were analyzed. Results Accuracy rate of pathological stage in detection of tumor markers was higher than CT scan, accuracy rate of pathologic typing of CT scan was higher than detection of tumor markers. CT scan imaging performance were 21 cases of retroperitoneal lymph node metastasis, liver metastasis, enhanced scanning renal disorder showed significant enhanced change. 17 case of local contour of the lower pole of the kidney, abnormal density shadow could be seen, obvious lesions enhancement could be seen in percutaneous medullary junction after enhancement, parenchymal phase were equidensite. 12 cases of obvious increase of renal contour, low density range could be seen with sharpness of border, uneven density, no obvious enhancement in lesions after enhancement. 10 cases were complicated with liver, peritoneal metastasis, soft-tissue mass could be seen in kidney, obvious lesions enhancement could be seen after enhancement. Conclusion CT and enhanced CT scanning iconography have obvious characteristics, enhanced CT scanning, tumor markers examination have different advantages in pathologic typing and pathological stage in renal carcinoma, combined detection has important clinical value in diagnosis of renal carcinoma.