不同病理类型肺癌HRCT征象与三种血清肿瘤标志物的相关性

Correlation between HRCT features and three kinds of serum tumor markers in different pathology subtypes of lung cancer

目的:探讨肺腺癌、肺鳞癌和小细胞肺癌的HRCT征象与三种血清肿瘤标志物浓度之间的相关性,提高肺癌的诊断水平。方法:选取111例经病理证实的肺癌患者作为观察对象,其中肺腺癌69例,肺鳞癌30例,小细胞肺癌12例。进行HRCT扫描和血清肿瘤标志物(CEA、CYFRA21-1及NSE)检测,分析不同病理类型肺癌的HRCT征象与三种血清肿瘤标志物的相关性。结果:111例肺癌中分叶征102例,毛刺征59例,胸膜凹陷征49例,血管集束征26例,空泡征55例。CEA在肺腺癌中的浓度最高[(13.43±24.81)ng/mL],CYFRA21-1在肺鳞癌中的浓度最高[(17.81±31.21)ng/mL],NSE在小细胞肺癌中的浓度值最高[(47.48±57.32)ng/mL]。不同HRCT征象的肺癌CEA浓度和CYFRA21-1浓度没有统计学差异。不同病理类型肺癌的CEA浓度没有统计学差异。肺鳞癌的CYFRA21-1浓度高于肺腺癌和小细胞肺癌(P<0.05)。小细胞肺癌NSE浓度显著高于肺鳞癌和肺腺癌(P<0.05)。结论:CEA、CYFRA21-1和NSE平均浓度值最髙的依次是肺腺癌、肺鳞癌和小细胞肺癌。CYFRA21-1浓度、NSE浓度的显著升高分别提示肺鳞癌、小细胞肺癌的可能性较大。有胸膜凹陷征的小细胞肺癌NSE的浓度最高。

Objective：To discuss the correlation between the HRCT features of pulmonary adenocarcinoma（AdCa）,squamous cell carcinoma（SqCa）,small cell lung cancer（SCLC）and the concentration level of three kinds of serum tumor marker,in order to improve the diagnosis accuracy of lung cancer.Methods：111cases of pathology confirmed lung cancer were recruited,including pulmonary AdCa（69cases）,SqCa（30cases）and SCLC（12cases）.HRCT and serum tumor marker（CEA,CYFRA21-1and NSE）examination were performed.The correlation between HRCT features in different pathology subtypes of lung cancer and three kinds of serum tumor marker were analyzed.Results：Of the 111 patients cases,there were lobulation sign（102patients）,spiculation sign（59patients）,pleural indentation sign（49patients）,vessel tracking sign（26patients）and vacuole sign（55patients）.The level of CEA was the highest[（13.43±24.81）ng/mL]in pulmonary AdCa,CYFRA21-1 was the highest [（17.81±31.21）ng/mL]in SqCa and NSE was the highest [（47.48±57.32）ng/mL]in SCLA.There was no statistical difference in CEA concentration and CYFR21-1concentration in lung cancer with different CT signs.No significant difference in the concentration of CEA in different pathology types of lung cancer.The CYFRA21-1of SqCa was higher than that of AdCa and SCLC（P0.05）.The NSE concentration of SCLC was significantly higher than that of SqCa and AdCa（P0.05）.Conclusion：The average highest level of CEA,CYFRA21-1and NSE was pulmonary adenocarcinoma,squamous cell carcinoma and small cell lung cancer,respectively.The concentration of CYFRA21-1and NSE increased significantly,which might indicate the high possibility of pulmonary squamous cell carcinoma and small cell lung cancer.Small cell lung cancer with pleural indentation sign showed the highest level of NSE.