简体中文

论著-头颈部

多层螺旋CT特征联合肿瘤标志物在肺癌诊断中的价值

作者:李建利

所属单位:河南省济源市中医院CT室(河南 济源 459000)

PDF

摘要

目的探讨多层螺旋CT(MSCT)特 征联合肿瘤标志物在肺癌诊断中的价值。 方法 选取2016年3月至2017年4月治疗的 疑似肺癌患者137例,最终确诊恶性病变 者83例,良性病变患者54例。所有患者均 行MSCT扫描以及肿瘤标志物CA125、CEA和 NSE检测。结果 恶性病变者CA125、CEA和 NSE明显高于良性病变者(P<0.05);MSCT 联合肿瘤标志物诊断恶性病变的灵敏度为 95.18%,明显高于MSCT、CA125、CEA和 NSE单独检查(P<0.05);MSCT联合肿瘤标 志物诊断恶性病变的特异度为90.74%, 明显高于CA125、CEA和NSE单独检查(P <0.05);非小细胞肺癌CA125明显高于小 细胞肺癌(P<0.05),而NSE明显低于小细 胞肺癌(P<0.05);非小细胞肺癌MSCT特 征中,支气管截断征、密度不均匀和/或 伴有坏死的比例分别为82.81%和75.00%, 明显高于小细胞肺癌(P<0.05),胸腔积 液的比例为18.75%,明显低于小细胞肺癌 (P<0.05)。结论 MSCT特征联合肿瘤标志 物在肺癌诊断中有较好的应用价值,同时 在鉴别诊断小细胞肺癌和非小细胞肺癌中 有一定作用。

Objective To investigate the value of multi-slice spiral CT features combined with tumor markers in the diagnosis of lung cancer. Methods 137 cases of suspected lung cancer patients were treated in our hospital from March 2016 to April 2017, there were 83 cases of final diagnosis of malignant lesions, and 54 cases of benign lesions, all patients were examined by MSCT scan and tumor standard CA125, CEA and NSE were detected. Results CA125, CEA and NSE in malignant lesions were significantly higher than those in benign lesions (P<0.05). The sensitivity of MSCT combined with tumor markers in the diagnosis of malignant lesions was 95.18%, which was significantly higher than that of MSCT, CA125, CEA and NSE (P<0.05). The specificity of MSCT combined with tumor markers in the diagnosis of malignant lesions was 90.74%, which was significantly higher than that of CA125, CEA and NSE (P<0.05). The CA125 of non small cell lung cancer was significantly higher than that of small cell lung cancer (P<0.05), while NSE was significantly lower than that of small cell lung cancer (P<0.05). In the MSCT characteristics of non-small cell lung cancer, the percentage of bronchial truncation, uneven density and /or necrosis were 82.81% and 75%,which were significantly higher than those of small cell lung cancer (P<0.05), the proportion of pleural effusion was 18.75%, which was significantly lower than that of small cell lung cancer (P<0.05). Conclusion The combination of MSCT features and tumor markers has a good application value in the diagnosis of lung cancer, and it has a certain role in the differential diagnosis of small cell lung cancer and non-small cell lung cancer.

【关键词】多层螺旋CT;肿瘤标志物;影像特征;小细胞肺癌;非小细胞肺癌

【中图分类号】R734.2;R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.08.018

前言

肺癌是我国常见恶性肿瘤,流行病学研究[1]显示肺癌的五年生存 率较低,仅有13%左右,近年来本病的发病率和死亡率均呈明显的上升 趋势,但早期肺癌(尤其是Ⅰ期肺癌)术后的10年生存率可达90%以上, 故此,肺癌的早期诊断和早期治疗对肺癌患者尤为关键。肺癌可分为 小细胞肺癌和非小细胞肺癌,相关文献[2]显示两种肺癌的治疗方法存 在一定差异,故而肺癌的分型诊断对提高肺癌患者的预后较为重要。