中央型肺鳞癌、小细胞肺癌CT征象与血清肿瘤标志物的关系及联合诊断的价值

Study on the Correlation of CT Features and Tumor Markers and on the Diagnostic Value of the Combination Both in Detection for Central Pulmonary SCLS and Squamous Carcinoma

目的探讨中央型肺鳞癌、小细胞肺癌CT征象与血清肿瘤标志物的关系及联合诊断的价值。方法收集54例经病理证实的中央型肺鳞癌及小细胞肺癌患者,同时行CT检查及血清肿瘤标志物CA125、CEA、CYFRA21-1、NSE、Pro GRP、SCC检测,将CT征象及血清肿瘤标志物进行对照研究。结果肿块的形态、密度、强化方式、支气管的形态、阻塞性征象以及淋巴结融合在肺鳞癌组与小细胞组之间差异有统计学意义(p<0.05);CYFRA21-1、NSE、pro GRP、SCC在鳞癌组与小细胞肺癌组之间差异有统计学意义,并且CYFRA21-1、SCC在鳞癌组较小细胞肺癌组高,而NSE、pro GRP在小细胞肺癌组较高;两者联合检测由于单项检测;CYFRA21-1与肿瘤的密度以及强化方式差异与统计学意义(p<0.05);CEA与淋巴结肿大之间差异有统计学意义(p<0.05)。结论 CT征象与血清肿瘤标志物联合检测有助于提高肺癌的检出率及诊断正确率;肺癌的肿块的密度、强化方式与CYFRA21-1有一定相关性;CEA与淋巴结肿大有一定相关性。

Objective To study on the correlation of CT features and tumor markers and on the diagnostic value of the combination both in detection for central pulmonary SCLS and squamous carcinoma. Methods 52 cases central pulmonary SCLS and squamous carcinoma confirmed by pathology received CT scan and the test of tumor markers which included CA125、CEA、CYFRA21-1、NSE、ProGRP、SCC.CT features were analysed comparatively with serum tumor markers test. Results There were significance between tumor features,density,enhancement, bronchial truncation,obstructive atelectasis,lymph node metastases（p〈0.05）.There were difference between CYFRA21-1,NSE,proGRP,SCC.CYFRA21-1,SCC of squamous carcinoma were higher than SCLC.NSE,proGRP of SCLC were higher than squamous carcinoma.The combination of CT features and test of tumor markers were better than the single one in detecting lung cancer.There were significance between CYFRA21-1 and density and enhancement（p〈0.05）.There were significance between CEA and lymph node metastases（p〈0.05）. Conclusion Combination of CT features and tumor markers could improve the accuracy rate in diagnosing lung cancer. Density and enhancement have certain correlation with CYFRA21-1.Lymph node metastases have certain correlation with CEA.