双排CT扫描、实验室检查应用于肺癌筛查中的准确性分析

Analysis of Accuracy of Double Row CT Scan,Laboratory Tests in Lung Cancer Screening

目的分析双排CT扫描、实验室检查应用于肺癌筛查中的准确性。方法选取2013年10月至2014年9月广元市第一人民医院呼吸科进行治疗的150例疑似肺癌患者作为研究对象,以病理诊断标准为金标准。初筛过程中,分别采用双排CT检测以及多肿瘤标志物蛋白芯片检测系统(C-12芯片)检测。比较两种检测方法及两种方法并联、串联在肺癌诊断中的价值。结果双排CT、多肿瘤标志物蛋白芯片检测系统阳性结果与病理检测相符的病例分别为101例和87例,双排CT检测与金标准的一致性检验结果κ=0.302(P<0.05);多肿瘤标志物蛋白芯片检测系统检测与金标准的一致性检验结果κ=0.200(P<0.05);双排CT检测联合多肿瘤标志物蛋白芯片检测系统检测的串联法、双排CT检测联合多肿瘤标志物蛋白芯片检测系统检测的并联法与病理检测结果相符的病例分别为67例和119例。联合检测串联法与金标准的一致性检验结果κ=0.112(P>0.05),联合检测并联法与金标准的一致性检验结果κ=0.291(P<0.05)。联合检测并联法的灵敏度为96.0%,高于其他检测方法,但该法的特异度最低(26.9%)。双排CT检测的灵敏度为81.5%,但其特异度、约登指数及阳性预测值均高于联合检测并联法(53.9%比26.9%,35.3%比22.9%,89.4%比86.2%)。结论双排CT扫描应用于肺癌筛查中具有较高的临床价值,值得推广使用。

Objective To analyze the accuracy of double row CT scan,laboratory tests in lung cancer screening. Methods Total of 150 patients with suspected lung cancers admitted to Guangyuan First People＇s Hospital from Oct. 2013 to Sep. 2014 were included in the study,with pathological diagnostic criteria as the gold standardand. The patients were detected with double row CT and multiple tumor markers protein chip detection system（ C-12 chips） during the preliminary screening. The diagnosis value of the two methods and the parallel,serial combined methods on lung cancer were compared. Results Cases detected by double row CT and multiple tumor markers protein chip detection system were separately 101 and 87. The kappa consistency test results of showed that,the kappa of double row CT and the gold standard was 0. 302（ P〈0. 05）,the kappa of multiple tumor markers protein chip detection system and the Gold standard was 0. 200（ P〈0. 05）; Cases detected by series connection bewteen double row CT and multiple tumor markers protein chip detection system and parallel connection bewteen double row CT and multiple tumor markers protein chip detection system were separately 67 and 119. the kappa of series connection was 0. 112（ P〉0. 05）,the kappa of parallel connection was 0. 291（ P〈0. 05）; Parallel connection showed highest sensitivity（ 96. 0%）but lower specificity（ 26. 9%）. Double row CT showed a moderate sensitivity with 81. 5%,and higher specificity,Youden index,positive predictive values than the parallel connection（ 53. 9% vs 26. 9%,35. 3% vs22. 9%,89. 4% vs 86. 2%）. Conclusion The double row CT scan has higher clinical value in lung cancer screening,thus is worth of promotion.