^(99)Tc^m-HL91乏氧显像联合血清CYFRA21-1、NSE、CEA检测对肺癌的诊断价值

The Clinical Value of ^(99)Tc^m-HL91 Hypoxia Imaging Combined with the Detection of Serum NSE,CEA and CYFRA21-1 in the Diagnosis of Lung Cancer

目的探讨99Tcm-HL91乏氧显像和血清细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)检测及其联合应用诊断肺癌的价值。方法选择肺部肿瘤患者63例,全部行99Tcm-HL91乏氧显像和血清CY-FRA21-1、NSE、CEA三种肿瘤标志物检测,分别计算两种方法及两种方法联合诊断肺癌的灵敏度、特异性和准确率并加以比较。结果 99Tcm-HL91乏氧显像诊断肺癌的灵敏度为85.4%、特异性为100%、准确率为88.9%,CYFRA21-1、NSE、CEA联合诊断肺癌的灵敏度为72.9%、特异性为86.7%、准确率为76.1%;与CYFRA21-1、NSE、CEA联合相比,99Tcm-HL91乏氧显像诊断肺癌具有较高的灵敏度和特异性,准确率相近;两种方法相结合诊断肺癌的灵敏度为95.8%、特异性为86.7%、准确率为93.6%。两法联合检测与单用一种方法相比,灵敏度和准确率均有提高(P<0.05),但特异性差异无统计学意义(P>0.05)。结论 99Tcm-HL91乏氧显像和CYFRA21-1、NSE、CEA检测在肺癌的诊断中具有重要价值,两者联合应用可提高对肺癌的诊断灵敏度和准确率。

Objective To investigate the value of 99Tern-HL91 hypoxia imaging combined the detection of serum neuron-specific enolase （NSE） , carcinoembryonie antigen （CEA） and eytokeratin 19 fragment （ CYFRA21-1 ） in the diagnosis of lung cancer. Methods 63 patients with lung neoplasm were carried out 99Tcm-HL91 hypoxia imaging, and the serum tumor markers levels of NSE, CEA and CYFRA21-1 were detected. The sensitivity, specificity and accuracy of each and combined method were calculated respectively and compared with each oth- er. Results The sensitivity, specificity and accuracy in diagnosis of lung cancer with 99Tcm-HL91 hypoxia ima- ging were 85. 4%, 100% and 88. 9% respectively; and with serum tumor markers NSE, CEA and CYFRA21-1 detection were 72.9%, 86.7% and 76.1% respectively. Compared with the detection of serum tumor marker levels of NSE, CEA and CYFRA21-1, 99Tcm-HL91 hypoxia imaging had the higher sensitivity and specificity, and similar accuracy. The sensitivity, specificity and accuracy of combined two methods in di- agnosis of lung cancer were 95.8%, 86.7% and 93.6% respectively. The sensitivity and accuracy of the combined method were significantly increased than single method （P 〈 0.05 ）, but there was no significant differ- ence between the specificity （P 〉0.05）. Conclusion 99Tem-HL91 hypoxia imaging and the detection of serum level of NSE, CEA and CYFRA21-1 have an important diagnostic value, and their combination could improve the sensitivity and accuracy in the diagnosis of lung cancer.