肺孤立结节患者CT表现与患者血清中CEA、CYFER21-1、NSE及病理结果的关系

Relationship of CT findings with serum CEA, CYFER21-1, NSE and pathological findings in patients with isolated nodules

目的探讨肺孤立结节患者CT表现与患者血清中癌胚抗原(CEA)、细胞角蛋白19片段(CYFER21-1)、神经特异性烯醇化酶(NSE)及病理结果的关系。方法回顾性分析2015年1月-2018年1月本院收治186例肺孤立结节患者的临床资料,比较患者胸部CT影像征象在肺良恶性结节的表现差异,并分析肺恶性结节CT影像征象、病理结果与血清CEA、CYFER21-1、NSE水平的关系。结果肺恶性结节在毛刺征、深分叶征、胸膜凹陷征、血管集束征、棘突征出现率高于肺良性结节,其钙化灶出现率低于肺良性结节(P<0.05);肺恶性结节伴有毛刺征、深分叶征、胸膜凹陷征、血管集束征、棘突征,患者血清CEA、CYFER21-1、NSE水平高于无毛刺征、深分叶征、胸膜凹陷征、血管集束征、棘突征患者(P<0.05);肺腺癌患者血清CEA水平高于肺鳞癌、肺小细胞癌(P<0.05);肺鳞癌患者血清CYFER21-1水平高于肺腺癌、肺小细胞癌(P<0.05);肺小细胞癌患者血清NSE水平高于肺腺癌、肺鳞癌(P<0.05)。结论肺孤立结节CT表现征象对鉴别结节病理良恶性质,反映肺癌肿瘤标志物水平具有一定的诊断价值,肺癌的具体病理类型与肿瘤标志物具有一定的相关性。

Objective To investigate relationship of CT findings and serum carcino-embryonic antigen(CEA), CYFER21-1, neurone specific enolase(NSE) and pathological findings in patients with isolated nodules. Methods The clinical data of 186 patients with isolated pulmonary nodules were retrospectively analyzed. All patients underwent multi-slice CT chest biopsy, 126 cases of malignant pulmonary nodules and 60 benign pulmonary nodules were confirmed by biopsy pathology or surgical pathology. The manifestations of chest CT images in benign and malignant pulmonary nodules were compared to analyze the CT images of malignant pulmonary nodules, pathological results and serum CEA, CYFER21-1, NSE levels. Results Malignant pulmonary nodules in burr, deep lobes sign, pleural indentation, vascular bundles signs, spine signs were higher than the benign pulmonary nodules. The incidence of calcification was lower than that of benign pulmonary nodules(P<0.05). The levels of serum CEA, CYFER21-1 and NSE in pulmonary malignant nodules with burr sign, deep lobule sign, pleural indentation, vascular bundle sign and spinous process sign were higher than those in patients without burr sign, deep lobule sign, pleural indentation, vascular bundle sign and spinous process sign(P<0.05). The serum CEA level of patients with lung adenocarcinoma was higher than that of lung squamous cell carcinoma and small cell lung cancer(P<0.05). The serum CYFER21-1 level of lung squamous cell carcinoma patients was higher than that of lung adenocarcinoma and small cell lung cancer(P<0.05). The serum NSE level of patients with cell carcinoma was higher than that of lung adenocarcinoma and lung squamous cell carcinoma(P<0.05). Conclusion CT signs of solitary pulmonary nodules have certain diagnostic value for differentiating benign and malignant nodules, reflecting the level of tumor markers in lung cancer. The specific pathological types of lung cancer are correlated with tumor markers.