多层螺旋CT平扫联合肿瘤标志物检测对早期肺癌的诊断价值

Value of Multislice CT Plain Scan Combined with Tumor Markers Detection in Diagnosis of Patients with Early Lung Cancer

目的探讨多层螺旋CT平扫联合肿瘤标志物检测对早期肺癌的诊断价值。方法选取2014年2月—2018年10月于我院收治的158例早期肺癌患者为肺癌组,并选取同期90例体检健康人群作为对照组,比较2组和不同病理类型患者中的癌胚抗原(CEA)、细胞角质蛋白21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、糖类抗原(CA125)血清水平,及各肿瘤标志物、多层螺旋CT单独及联合诊断早期肺癌的特异性、敏感性、准确率。结果肺癌组的CEA、CYFRA21-1、NSE、CA125血清水平均显著高于对照组(P<0.05);腺癌中的CEA、CA125血清水平高于鳞癌和小细胞癌(P<0.05),鳞癌和小细胞癌的血清CEA、CA125水平比较差异无统计学意义(P>0.05),腺癌、鳞癌中的CYFRA21-1血清水平高于小细胞癌,血清NSE水平低于小细胞癌(P<0.05),腺癌和鳞癌的血清CYFRA21-1、NSE水平比较差异无统计学意义(P>0.05)。4种肿瘤标志物联合多层螺旋CT平扫检测的敏感性、特异性、准确率高于肿瘤标志物单独检测、单一多层螺旋CT平扫和4种肿瘤标志物的联合检测(P<0.05)。结论多层螺旋CT平扫联合多种肿瘤标志物检测可提高早期肺癌的准确率及敏感性,对于肺癌的早期诊断有更高的临床价值。

Objective To investigate value of multislice CT plain scan combined with tumor markers detection in diagnosis of patients with early lung cancer. Methods A total of 158 patients with early lung cancer admitted during February 2014 and October 2018 were selected as lung cancer group, and other 90 healthy people taking medical examinations at the same period were selected as control group. In two groups, serum levels of carcinoembryonic antigen (CEA), cytokeratin fragment antiogen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) and cancer antigen 125 (CA125) of patients with different pathological types were compared, and values of specificity, sensitivity and accuracy of various tumor markers, multislice CT alone and combined diagnosis of patients with early lung cancer were also compared. Results Serum levels of CEA, CYFRA21-1, NSE and CA125 in lung cancer group were significantly higher than those in control group ( P <0.05). Serum levels of CEA and CA125 in adenocarcinomas were significantly higher than those in squamous cell carcinomas and small cell carcinomas ( P <0.05), but there were no significant differences in serum CEA and CA125 levels between squamous cell carcinomas and small cell carcinomas ( P >0.05). In adenocarcinoma and squamous cell carcinoma, serum levels of CYFRA21-1 were significantly higher, while serum levels of NSE were lower than those in small cell carcinomas ( P <0.05), but there was no significant difference in serum CYFRA21-1/NSE level between adenocarcinoma and squamous cell carcinoma ( P >0.05). Values of sensitivity, specificity and accuracy of the four tumor markers combined with multislice CT plain scan detection were significantly higher than those by single detection of tumor markers, single multislice CT plain scan and combined detection of the four tumor marker ( P <0.05). Conclusion Multislice CT plain scan combined with multiple tumor markers detection may improve accuracy and sensitivity of patients with early lung cancer, and it has better clinical value for early diagnosis of lung cancer.