目的 探讨CT引导经皮肺穿刺活 检术联合血清肿瘤标志物诊断肺癌临床应 用价值。方法 分析我院2010年1月-2016 年1月收治的肺癌患者临床资料，经纳入 与排除后共有78例患者参与本次研究。 根据TNB送检检结果，根据肺癌的良恶性 将所有患者分为良性组与恶性组，其中 23例患者为非恶性肿瘤，纳入良性组； 另55例患者为肺癌，纳入恶性组。收集 穿刺结果、病理诊断最终结果及并发症 发生情况。分析TNB敏感度、特异度、精 准度，比较术前及术后12个月患者CEA、 NSE、CYFRA21-1水平。结果 恶性组患者 中83.64%为恶性肺癌，其中腺癌65.22%、 鳞癌15.57%、小细胞癌15.22%。其他类 型肺癌占5.45%，包括腺鳞癌66.67%、肉 瘤样癌33.33%、恶性淋巴瘤33.33%。良 性组患者中肺炎60.87%，包括真菌性肺 炎57.14%、机化性肺炎21.43%、肉芽肺 炎7.14%。肺结核13.04%、尘肺1.82%、 炎性假瘤8.70%、坏死组织8.70%、纤维 组织1.82%。本组患者中经病理诊断有 74.35%恶性肺癌，25.64%良性肺癌。恶 性组TNB病理诊断结果正确率显著高于良 性组(P<0.05)。经过TNB诊断肺癌，其敏 感度为96.36%、特异度为100.00%及准确 度为97.44%。治疗前恶性组患者CEA、 NSE、CYFRA21-1水平显著高于良性组 (P<0.05)。治疗后，两组患者CEA、NSE、 CYFRA21-1水平较治疗前降低，但恶性组 患者CEA、NSE、CYFRA21-1水平仍然高于 良性组(P<0.05)。气胸2.56%，微出血 67.69%，12.82%胸闷、心慌，所有患者经 对症治疗后痊愈。结论 CT引导经皮肺穿 刺活检术联合血清肿瘤标志物可作为临床 诊断肺癌的有效措施，两者联合诊断能提 高肺癌的检出率及正确性。

Objective To investigate the diagnosis value of CT-guided percutaneous transthoracic needle biopsy (TNB) combined with serum tumor markers for lung cancer. Methods The clinical data of the lung cancer patients treated in our hospital from January 2010 to January 2016 were analyzed. After inclusion and exclusion, 78 patients were enrolled in the study. Patients were divided into benign group (n=23) and malignant group (n=55) according to the TNB results. The TNB results, pathological results and complications of all patients were collected. Thereafter, the sensitivity, specificity and accuracy of TNB were analyzed. Also, the levels of CEA, NSE, and CYFRA21-1 were measured before and 12 months after surgery. Results 83.64% of malignant lung cancer patients were consisted of 65.22% of adenocarcinoma, 15.57% of squamous cell carcinoma and 15.22% of small cell carcinoma. 5.45% of non-malignant lung cancer patients included 66.67% of adenosarcoma, 33.33% of sarcomatoid carcinoma and 33.33%of malignant lymphoma. In the benign group, 60.87% of pneumonia patients included 57.14% of fungal pneumonia, 21.43% of mechanized pneumonia, 7.14% of granulation pneumonia, 13.04% of tuberculosis, 1.82% of pneumoconiosis, 8.70% of inflammatory pseudotumor, and 1.82% of fibrous tissue. According to the pathological results, malignant lung cancers and benign lung cancers accounted for 74.35% and 25.64%, respectively. The accuracy rate of pathological diagnosis in the malignant group was higher than that of the benign group (P<0.05). The sensitivity, specificity and accuracy of TNB in the diagnosis of lung cancer were 96.36%, 100.00% and 97.44%, respectively. The levels of CEA, NSE and CYFRA21-1 in the malignant group were significantly higher than those in the benign group before treatment (P<0.05), which were decreased in both groups after treatment, and were still lower in the benign group than in the malignant group (P<0.05). The complications including pneumothorax (2.56%), microbleeds (67.69%), chest tightness (12.82%) were cured after symptomatic treatment. Conclusion CT-guided percutaneous transthoracic needle biopsy combined with serum tumor markers is effective and safe to improve the detection rate of lung cancer, which can be used as an effective clinical diagnosis method.