肺癌患者CT影像学特征与特异性标记物相关性及联合诊断价值研究

The correlation between CT imaging features and specific makers expression in patients with lung cancer and the evaluation of diagnostic value of combined diagnosis

目的探究肺癌患者的CT扫描影像学特征与血清C12多肿瘤特异性标记物的表达相关性以及两者联用的诊断价值。方法 30例确诊原发性肺癌患者为研究对象,另选取30名健康志愿者为对照组,对肺癌患者及正常人体血清中C12多肿瘤特异性标记物进行定量检测以分析CT的影像学特征与该血清特异性标记物[糖链抗原199(CA 199)、糖链抗原242(CA242)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、铁蛋白(Fe)、人绒毛膜促性腺激素(HCG)、甲胎蛋白(AFP)、前列腺特异性抗原(PSA)、游离型前列腺特异性抗原(FPSA)、癌抗原125(CA125)、癌抗原153(CA 153)和生长激素(HGH)]的表达相关性并评估联用诊断价值。结果肺癌组多肿瘤标记物CA 199、CA242、NSE、CEA、Fe、HCG、AFP、CA125、CA 153显著高于对照组,差异均有统计学意义(P<0.05);2组间PSA、FPSA和HGH含量比较,差异均无统计学意义(P>0.05)。将肺癌患者根据CT影像学特征再分组比较C12多肿瘤特异性标记物水平,结果显示肿瘤>5 cm患者与≤5 cm的患者组间、有无坏死空洞组间、有无毛刺征象组间、有无深分叶征象组间差异均有统计学意义(P<0.05);而CT影像学特征中的不同病灶部位组间C12特异性标记物差异无统计学意义(P>0.05)。结论肺癌CT多期增强扫描影像学特征中的肿瘤大小、有无坏死空洞、毛刺征象、深分叶征象与C12多肿瘤特异性标记物的表达有相关性,不同病灶部位则与特异性标记物表达无关。可将CT影像与特异性标记物联用,有利于更准确的诊断疾病。

Objective To investigate the correlation between CT imaging features and C12 multiple tumor markers expression in patients with lung cancer,and to explore the diagnostic value of combined diagnosis. Methods Thirty patients with primary lung cancer who were admitted and treated in our hospital in the last two years were enrolled as lung cancer group,and the other 30 healthy volunteers were served as control group. The serum levels of multiple tumor markers including CA199,CA242,NSE,CEA,Fe,HCG,AFP,CA125,CA153,PSA,FPSA and HGH were detected for both groups,then the correlation between CT imaging features and specific makers expressions was analyzed,moreover,the diagnostic value of combined diagnosis was evaluated. Results The serum levels of CA199,CA242,NSE,CEA,Fe,HCG,AFP,CA125 and CA153 in lung cancer group were significantly higher than those in control group（P〈0.05）,however,there were no significant differences in the serum levels of PSA,FPSA and HGH between two groups（P〉0.05）. Moreover there were significant differences in the serum levels of C12 multiple tumors markers between the patients with tumor size〉 5cm and the patients with tumor size≤5cm,between necrosis cavity group and no necrosis cavity group,between sentus group and no sentus group,between deep lobulation group and no deep lobulation group（P〈0.05）. However there were no significant differences in the serum levels of C12 multiple tumors markers among different lesion site groups showed by CT image（P〉0.05）.Conclusion The tumor size,necrosis cavity,sentus and deep lobulation showed by CT enhancement scanning images are correlated with the expressions of C12 multiple tumor makers,however,different lesion sites are not related with the expressions of C12 multiple tumor makers,thus,to combine CT images with multiple tumor markers detection can enhance diagnostic accuracy. in diagnosis will improve diagnostic accuracy.