老年肺癌CT影像学特征与特异性标记物的相关性研究及联合诊断

Correlation between CT Imaging Features and Specific Markers and Their Combined Diagnostic Value in Lung Cancer in Older Patients

目的探究老年肺癌CT影像学特征与特异性标记物的相关性及联合诊断的临床价值。方法选取2015年3月~2017年12月中南大学湘雅医院收治的130例老年肺癌患者(肺癌组)以及130例健康体检者(对照组)为研究对象。进行C-12多肿瘤标记物检测和CT扫描,根据影像学特征进一步分组研究,分析患者CT影像学特征与肿瘤特异性标记物表达的相关性以及联合诊断的临床意义。结果肺癌组的糖链抗原199 (CA199)、糖链抗原242 (CA242)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、铁蛋白(Fe)、人绒毛膜促性腺激素(HCG)、癌抗原125 (CA125)及癌抗原153 (CA153)和对照组比较,差异有统计学意义(P <0.05)。> 5 cm组、有坏死空洞组、有毛刺征组和有深分叶征组的C-12肿瘤特异性标记物水平与相对应的≤5 cm组、无坏死空洞组、无毛刺征组和无深分叶征组相比较,差异均有统计学意义(P <0.05)。结论 CT影像特征中肿瘤直径、有无毛刺征、有无深分叶及有无坏死空洞与肿瘤特异性标记物的表达有一定的相关性;CT影像联合C-12多肿瘤标记物检测诊断老年肺癌具有良好的临床价值。

Objective To explore the correlation between CT imaging features and specific markers and their combined diagnostic value in lung cancer in older patients.Methods From March 2015 to December 2017,130 older patients with lung cancer(lung cancer group)and 130 healthy people(control group)were included in Xiangya Hospital of Central South University.C-12 multiple tumor markers detection and CT scanning were performed.The patients were subgrouped according to the imaging features.The correlation between the imaging features of CT and the expression of tumor specific markers,and the clinical significance of combined diagnosis were analyzed.Results There were significant differences in carbohydrate antigen(CA)199,CA242,neuron specific enolase(NSE),carcinoembryonic antigen(CEA),ferritin(Fe),human chorionic gonadotropin(HCG),cancer antigen(CA)125 and CA153 between lung cancer group and control group(P<0.05).The levels of C-12 tumor specific markers in group with tumor size>5 cm,group with necrotic cavity,group with burr sign,and group with deep lobular sign were significantly different from those in group with tumor size≤5 cm,group without necrotic cavity,group without burr sign,and group without deep lobular sign(P<0.05).Conclusion There is a certain correlation between CT imaging features(size,burr,deep lobule and necrotic cavity)and the expression of tumor specific markers.CT imaging combined with C-12 multiple tumor markers has a good clinical value in the diagnosis of lung cancer in older people.