实性型和含气型周围型肺癌CT与病理及血清肿瘤标志相关性研究

Correlation of CT with pathology and serum tumor markers in solid and aerated peripheral lung cancer

目的:探讨实性型和含气型周围型肺癌病理类型与CT影像表现学及血清肿瘤标志CEA、NSE和CYFRA21-1的相关性。方法:病理确诊的周围型肺癌患者76例,经64排螺旋CT薄层扫描或4排螺旋CT(high-resolution CT,HRCT)及常规CT增强扫描;同时进行CEA、NSE和CYFRA21-1血清肿瘤标志水平的测定,并进行相关与回归分析。结果:按联系强度由大到小,55例实性型周围型肺癌与分叶征、深分叶、鳞癌、血管参与、切迹征、腺癌、CEA和CYFRA21-1存在直线相关与回归,P<0.05;含气型肺癌与CEA、CYFRA21-1、磨玻璃影、支气管气相或空泡征、腺癌、浅分叶、毛刺征和血管参与存在直线相关与回归,P<0.05;45例腺癌与血管参与、毛刺征、磨玻璃影、边界模糊、分叶征、CEA、含气征和浅分叶存在直线相关与回归,P<0.05;24例鳞癌与实性型、切迹征、CYFRA21-1、分叶征、深分叶、CEA、NSE和血管参与存在直线相关与回归,P<0.05。结论:通过对周围型肺癌病变进行实性型和含气型分型,在一定程度上明确了定性诊断的方向,而联合应用血清肿瘤标志检测结果,可进一步提高≤3cm周围型肺癌诊断的准确率及检出率。

OBJECTIVE：To evaluate the correlation of pathological type, CT and serum tumor markers （CEA, NSE, CYFRA21-1） of solid and aerated peripheral lung cancer. METHODS： Seventy-six cases of pe ripheral lung cancer patients confirmed by pathology were under 64 row detecters helical CT or HRCT （4 row detectors helical CT） and routine CT examination. The serum tumor markers consisting of CEA, NSE and CYFRA21 1 were measuced. The correlation analysis and regressive analysis were performed according to the two variance. RESULTS： According to the correlation intensity （greater to lesser）, there were linear correlation and regressive correlation between the solid peripheral lung cancer and segmented, deep segmented, squeamous carcinoma, vascular involvement, notch sign, adenocarcinoma, CEA, CYFRA21-1, respectirely, P〈0. 05; There were linear correlation and regressive correlation between the aerated lung cancer and CEA, CYFRA21-1, ground glass sign, air-bronchus or vacuole sign, adenocarcinoma, superficial segmented, barb sign, vascular involvement, respectirely, P〈0.05. There were linear correlation and regressive correlation between the adenocarcinoma and vascular involvement, barb sign, ground glass sign, ill defined margin, segmented, CEA, aerated sign, air-bronchus, superficial segmented, respectirely, P〈0. 05. There were linear correlation and regressive correlation between the squeamous carcinoma and solid type, notch sign, CYFRA21-1, segmented, deep segmented, CEA, NSE, vascular involvement, respectirely, P〈0. 05. CONCLUSION： The diagenosis can be identified by dividing peripheral lung cancer into solid and aerated type better, and the accuracy and detected rate of peripheral lung cancer （43 cm） diagnosis can be improved by combining the results of serum tumor markers,