^(18)F-FDG符合线路显像联合肿瘤标志物对肺占位性病变的诊断价值

Diagnostic value of ^(18)F-FDG coincidence imaging combined with tumor markers in the lung space-occupying lesions

目的 :分析^(18)F-FDG符合线路显像联合肿瘤标志物对肺占位性病变的诊断及鉴别诊断价值。方法 :收集经胸部影像学检查发现的肺占位性病变42例,均完善^(18)F-FDG符合线路显像检查,同时行4项血清肺肿瘤标志物——细胞角蛋白-19片段抗原(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)及糖类癌抗原125(CA125)的实验室测定。按肺占位性病变在^(18)F-FDG符合线路显像上靶/非靶比值(T/NT)的区别,对相应的FDG浓聚状况和特点展开剖析,若病变局部T/NT≥2.0则判断为阳性(肺恶性肿瘤)。肺4项血清肿瘤标志物中,1项或以上超出参考范围即为阳性(肺恶性肿瘤)。结果:42例中,病理示恶性肿瘤33例,良性病变9例。^(18)F-FDG符合线路显像法诊断肺恶性肿瘤的敏感度、特异度、阳性预测值、阴性预测值、准确率,分别为87.88%、66.67%、90.63%、60.00%、83.33%,与病理结果差异无统计学意义(χ~2=0.068,P=0.794);血清肺肿瘤标志物法分别为57.58%、88.89%、95.00%、36.36%、64.29%,与病理结果比较差异有统计学意义(χ~2=8.640,P=0.003);联合前2种方法诊断分别为93.94%,66.67%,91.18%,75.00%,88.10%,与病理结果比较差异无统计学意义(χ~2=0.084,P=0.786)。结论 :^(18)F-FDG符合线路显像联合肿瘤标志物对肺占位性病变的诊断最具临床参考价值。

Objective：To analyze the clinical value of^（18）F-FDG coincidence imaging combined with tumor markers in the diagnosis of malignant lung space-occupying lesions. Methods：Forty-two patients with lung space-occupying lesions in chest radiography were collected. All patients underwent^（18）F-FDG coincidence line imaging examination. At the same time,four serum lung tumor markers,cytokeratin-19 fragment antigen（CYFRA21-1）,neuron specific enolase（NSE）,carcinoembryonic antigen（CEA）and carbohydrate antigen 125（CA125） were detected. According to the difference of the target/non-target ratio（T/NT） between^（18）F-FDG and line-occupying lesion,the corresponding status and characteristics of FDG concentration were analyzed. Local T/NT≥2.0 was judged as positive（lung cancer）,and if one or more than one of the four serum tumor markers beyonded the reference range,the patient was judged as positive（lung cancer）. Results：A total of 42 patients were included in this study.The final pathologic findings were 33 cases of malignant tumors and 9 cases of benign lesions. The 3 methods for screening and identifying lung malignancies were analyzed using the chi-square check match table. For the sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the diagnosis of the disease,^（18）F-FDG coincided the corresponding values of line imaging were 87.88%,66.67%,90.63%,60.00% and 83.33% respectively. There were no significant differences between this method and pathological diagnosis（χ~2=0.068,P=0.794）. The corresponding values of serum lung tumor markers were57.58%,88.89%,95.00%,36.36% and 64.29%,respectively. There were significant differences between this method and pathological diagnosis（χ~2=8.640,P=0.003）. The corresponding values of the two methods were 93.94%,66.67%,91.18%,75.00% and88.10% respectively. There were no statistical differences between the two methods（χ~2=0.084,P =0.786）. Conclusion：In the above diagnostic methods,^（18）F-FDG coincidence line imaging combined with tumor markers is the most valuable clinical reference for the diagnosis of pulmonary space-occupying lesions.