超声内镜检查联合血清嗜铬粒素A检测对消化道神经内分泌肿瘤的诊断价值

Diagnostic value of endoscopic ultrasonography combined with serum chromogranin A detection in digestive tract neuroendocrine neoplasm

目的探讨超声内镜检查联合血清嗜铬粒素A(CgA)检测诊断消化道神经内分泌肿瘤(NEN)的价值。方法回顾性分析258例疑似消化道NEN患者的超声内镜检查和CgA检测结果,以病理结果为金标准,比较单独超声内镜检查、CgA检测与两者联合对消化道NEN的诊断效能。结果超声内镜检查与病理检查结果的一致性一般(Kappa值为0.703),其诊断NEN的灵敏度为84.17%、特异度为55.56%、准确度为82.17%;血清CgA检测与病理检查结果的一般性较好(Kappa值为0.786),其诊断NEN的灵敏度为87.08%、特异度为77.78%、准确度为86.43%;超声内镜检查与血清CgA检测联合与病理检测结果的一般性较好(Kappa值为0.836),其诊断NEN的灵敏度为89.58%、特异度为83.33%、准确度为89.15%,均高于单一检测或检查(均P<0.05)。结论与单一检测或检查比较,超声内镜检查联合CgA检测诊断消化道NEN的效能更佳。

Objective To investigate the diagnostic value of endoscopic ultrasonography combined with serum chromogranin A(CgA)detection in digestive tract neuroendocrine neoplasm(NEN).Methods The results of endoscopic ultrasonography and CgA detection of 258 patients with suspected gastrointestinal NEN were retrospectively analyzed,the pathological result was taken as gold standard,and then the diagnostic efficiency for digestive tract NEN was compared among endoscopic ultrasonography alone,CgA detection alone,and their combination.Results A fair consistency of endoscopic ultrasonography and pathological examination results was observed(Kappa value:0.703),and endoscopic ultrasonography had a sensitivity of 84.17%,a specificity of 55.56%,and an accuracy of 82.17%for NEN diagnosis;a favorable consistency of serum CgA detection and pathological examination results was observed(Kappa value:0.786),and serum CgA detection had a sensitivity of 87.08%,a specificity of 77.78%,and an accuracy of 86.43%for NEN diagnosis;a favorable consistency of the combination of endoscopic ultrasonography plus serum CgA detection and pathological examination results was observed(Kappa value:0.836),and the combined detectio n had a sensitivity of 89.58%,a specificity of 83.33%,and an accuracy of 89.15%for NEN diagnosis,which was higher than single detection or examination(all P<0.05).Conclusion Compared with single detection or examination,endoscopic ultrasonography plus serum CgA detection achieves better diagnostic efficiency for digestive tract NEN.