多层螺旋CT特征联合肿瘤标志物在肺癌诊断中的价值

The Value of Multi-slice Spiral CT Features Combined with Tumor Markers in the Diagnosis of Lung Cancer

目的探讨多层螺旋CT(MSCT)特征联合肿瘤标志物在肺癌诊断中的价值。方法选取2016年3月至2017年4月治疗的疑似肺癌患者137例,最终确诊恶性病变者83例,良性病变患者54例。所有患者均行MSCT扫描以及肿瘤标志物CA125、CEA和NSE检测。结果恶性病变者CA125、CEA和NSE明显高于良性病变者(P<0.05);MSCT联合肿瘤标志物诊断恶性病变的灵敏度为95.18%,明显高于MSCT、CA125、CEA和NSE单独检查(P<0.05);MSCT联合肿瘤标志物诊断恶性病变的特异度为90.74%,明显高于CA125、CEA和NSE单独检查(P<0.05);非小细胞肺癌CA125明显高于小细胞肺癌(P<0.05),而NSE明显低于小细胞肺癌(P<0.05);非小细胞肺癌MSCT特征中,支气管截断征、密度不均匀和/或伴有坏死的比例分别为82.81%和75.00%,明显高于小细胞肺癌(P<0.05),胸腔积液的比例为18.75%,明显低于小细胞肺癌(P<0.05)。结论 MSCT特征联合肿瘤标志物在肺癌诊断中有较好的应用价值,同时在鉴别诊断小细胞肺癌和非小细胞肺癌中有一定作用。

Objective To investigate the value of multi-slice spiral CT features combined with tumor markers in the diagnosis of lung cancer. Methods 137 cases of suspected lung cancer patients were treated in our hospital from March 2016 to April 2017, there were 83 cases of final diagnosis of malignant lesions, and 54 cases of benign lesions, all patients were examined by MSCT scan and tumor standard CA125, CEA and NSE were detected. Results CA125, CEA and NSE in malignant lesions were significantly higher than those in benign lesions（P〈0.05）. The sensitivity of MSCT combined with tumor markers in the diagnosis of malignant lesions was 95.18%, which was significantly higher than that of MSCT, CA125, CEA and NSE（P〈0.05）. The specificity of MSCT combined with tumor markers in the diagnosis of malignant lesions was 90.74%, which was significantly higher than that of CA125, CEA and NSE（P〈0.05）. The CA125 of non small cell lung cancer was significantly higher than that of small cell lung cancer（P〈0.05）, while NSE was significantly lower than that of small cell lung cancer（P〈0.05）. In the MSCT characteristics of non-small cell lung cancer, the percentage of bronchial truncation, uneven density and/or necrosis were 82.81% and 75%,which were significantly higher than those of small cell lung cancer（P〈0.05）, the proportion of pleural effusion was 18.75%, which was significantly lower than that of small cell lung cancer（P〈0.05）.Conclusion The combination of MSCT features and tumor markers has a good application value in the diagnosis of lung cancer, and it has a certain role in the differential diagnosis of small cell lung cancer and non-small cell lung cancer.