肿瘤标志物联合CT在肺癌纵隔淋巴结转移诊断中的应用

Application of tumor markers combined with spiral CT to diagnosis of mediastinum lymph node metastasis in lung cancer

目的分析CT扫描、肿瘤标志物检测及两种方法联合应用判断淋巴结转移的检出率及检出的灵敏度和准确率,探讨肿瘤标志物联合CT扫描对肺癌淋巴结转移的诊断价值及临床意义。方法选取2010年9月至2011年8月在保定市第三医院住院的肺癌患者110例,其中男性64例,女性46例;年龄41～71岁。使用西门子螺旋CT机扫描,扫描条件:130 kV,110 mAs。采用C-12型肿瘤诊断用蛋白芯片试剂盒进行肿瘤标志物检测。结果 CT对纵隔淋巴结转移诊断正确的有33例,敏感性为67.35%,特异性为70.49%;肿瘤标志物对纵隔淋巴结转移诊断的敏感性77.55%,特异性59.02%;肿瘤标志物联合CT检查对纵隔淋巴结转移诊断的敏感性91.84%,特异性65.57%,准确率为77.27%,与单项检查比较,敏感性明显升高(P<0.01)。结论应用多种肿瘤标志物蛋白芯片技术和螺旋CT联合分析,相对于单独应用一种检查技术对于肺癌患者纵隔淋巴结转移检出的敏感性、准确率有所增高,可以提高肺癌及纵隔淋巴结转移的诊断和肺癌TNM分期的准确率。

Objective To analyze the MLNM detection rate, sensitivity and accuracy with spiral CT scanning, tumor markers and both of them and assess the value of the combination of tumor markers and CT scanning in clinic diagnosis of MLNM in lung cancer. Methods 110 cases （male 64, female 46, aged 41 to 47） hospitalized in Baoding No.3 hospital from September 2010 to August 2011 were selected. Radiations were taken with a Siemens spiral CT machine, under 130 kV, 110 mAs. C-12 protein chip system for multi-tumor marker detection was used. Results Positive diagnosis of MLNM with CT was 33, with sensitivity of 67.35% and specificity of 70.49%. As to tumor markers, the sensitivity was 77.55% and the specificity was 59.02%. When combined, the sensitivity was significantly higher （P〈0.01） up to 91.84%, and the specificity was 65.57%, the accuracy was 77.27%. Conclusion The combination of Multi-Tumor Marker Protein Chip technique and spiral CT, comparing with either single technique, can significantly increase the diagnosis sensitivity and accuracy of MLNM, furthermore increase the diagnosis accuracy of TNM stages in lung cancer.