胸部CT及血清肿瘤标志物检测对肺癌筛查的价值

Chest computer tomography and serum tumor markers for lung cancer screening

目的 评价胸部CT和肿瘤标志物检测对体检人群肺癌早期筛查的价值.方法 对88 596例参加健康体检的人群,依据所选套餐应用胸部CT、胸部DR、肿瘤标志物等检测项目,肺癌患者由专业医生依据阳性结果进行综合判断,并采用受试者工作特征曲线（ROC）评价肿瘤标志物对肺癌的诊断价值.结果 2007年至2011年五年间,体检中心肺癌的平均检出率为59.8/10万,男性为42.9/10万,女性为92.2/10万.肺癌的检出率随年龄增加而增加,女性肺癌的检出率总体高于男性.胸部CT的阳性检出率约为94.3％,约为胸部DR的2倍,且癌胚抗原CEA检测作为辅助手段对肺癌的早期诊断具有较高的灵敏度（73.6％）和特异度（57.1％）.结论 体检中心应重视高危人群筛查,不断采用新技术提高早期肺癌的诊断.

Objective To assess the value of chest computer tomography （CT） and serum tumor marker in lung cancer screening among health check-up populations.Methods A total of 88 596 adults who had a medical check-up （including chest CT,chest DR,and tumor biomarkers test） in our center were enrolled in this investigation.Clinical diagnosis of lung cancer was confirmed by three professional doctors.Receiver operating characteristic （ROC） curve was used to assess the relationship between serum level of tumor biomarkers and lung cancer.Results The average detection rate of lung cancer was 59.8/100 000 in our center during 2007 and 2011 （men 42.9/100 000,women 92.2/100 000）.Rate of positive results of chest CT was 94.3％,which was approximately 2 times of chest DR.Moreover,carcinoembryonic antigen （CEA） testing was effective in early diagnosis of lung cancer with higher sensitivity （73.6％） and specificity （57.1％）.Conclusion This study suggests that health checkup centers should pay more attention to lung cancer screening in high risk populations,and new technologies might be used to facilitate the early diagnosis of lung cancer.