常规超声、超声造影及肿瘤标志物联合评分在肺周围型病变良恶性诊断中的价值

Value of combined conventional ultrasound,contrast-enhanced ultrasound and tumor markers in differential diagnosis of benign and malignant peripheral pulmonary lesions

目的探讨常规超声、超声造影及肿瘤标志物联合评分在肺周围型病变良恶性鉴别诊断中的应用价值。方法选取我院经穿刺活检或术后病理检查确诊的肺周围型病变患者76例,其中良性30例,恶性46例,比较良、恶性病变常规超声、超声造影及肿瘤标记物单一检查方法评分及三种检查方法联合评分;绘制受试者工作特征(ROC)曲线,计算各评分对应的曲线下面积、截断值、诊断敏感性及特异性,并对其进行比较。结果肺周围型良、恶性病变常规超声、超声造影及肿瘤标记物联合评分分别为(6.90±2.27)分、(11.93±2.29)分,二者比较差异有统计学意义(P<0.05);ROC曲线显示常规超声、超声造影、肿瘤标记物单一检查方法评分及三种检查方法联合评分的截断值分别为1.5分、6.5分、1.5分及8.5分时,诊断肺周围型恶性病变的曲线下面积分别为0.801、0.887、0.754及0.921,对应的敏感性和特异性分别为89.1%、65.6%,71.7%、93.1%和76.1%、65.5%,95.7%、76.7%,其中三种检查方法联合评分的ROC曲线下面积、诊断敏感性均高于常规超声、超声造影、肿瘤标记物单一检查方法评分。结论常规超声、超声造影及肿瘤标志物联合评分对肺周围型病变良恶性鉴别诊断有较高价值。

Objective To explore the application value of combined conventional ultrasound,contrast-enhancedultrasound(CEUS)and tumor markers in the differential diagnosis of benign and malignant peripheral pulmonary lesions.MethodsSeventy-six patients with histopathologically confirmed peripheral pulmonary lesions(30 benign and 46 malignant)were enrolled in this study.Conventional ultrasound,CEUS and tumor marker detection were performed on each patients.Thescores of three methods and the combination of three methods were recorded and compared.Area under receiver operatingcharacteristic(ROC)curve was drawn,the cutoff value of the score,the diagnostic sensitivity and specificity were calculated andcompared.ResultsThe combined score of malignant lesions was significantly higher than that of benign lesions(11.93±2.29 vs.6.90±2.27,P<0.05).The ROC curve analysis showed that the cutoff value of conventional ultrasound score,CEUS score,tumormarkers score and the combined score were 1.5,6.5,1.5 and 8.5,respectively.The sensitivity and specificity were 89.1%,65.6%,71.7%,93.1%and 76.1%,65.5%,95.7%,76.7%,respectively.The area under the curve and diagnostic sensitivity of the combinedscores were significantly higher than those of any single method score.ConclusionThe combined score of conventional ultrasound,CEUS and tumor marker are of high value in the differential diagnosis of benign and malignant peripheral pulmonary lesions.