AFP、CYFRA21-1、NSE及CT征象在孤立性肺结节性质中鉴别价值

The value of AFP,CYFRA21-1,NSE and CT signs in distinguishing the nature of solitary pulmonary nodules

目的探究甲胎蛋白(AFP)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)及CT征象在孤立性肺结节性质中鉴别价值。方法选取2019年1月至2021年1月四川省江油市人民医院呼吸科206例孤立性肺结节患者,依据结节性质分为恶性组(n=103)与良性组(n=103)。比较两组CT征象、AFP、CYFRA21-1、NSE水平,分析CT征象与AFP、CYFRA21-1、NSE水平相关性,绘制受试者工作(ROC)曲线,评价AFP、CYFRA21-1、NSE及CT征象在孤立性肺结节性质中鉴别价值,并分析CT征象、AFP、CYFRA21-1、NSE水平与孤立性肺结节性质的关系。结果恶性组毛刺征、分叶征、胸膜凹陷征比例及血清AFP、CYFRA21-1、NSE水平均高于良性组,差异有统计学意义(P<0.05);相关性分析可知,孤立性肺恶性结节患者CT征象与血清AFP、CYFRA21-1、NSE水平有关(P<0.05);绘制ROC曲线,评价CT征象、血清AFP、CYFRA21-1、NSE水平对孤立性肺结节的鉴别诊断价值,发现CT征象联合血清指标鉴别诊断AUC为0.950最大,具有良好诊断效能;Logistic回归分析中,结果可见毛刺征、分叶征、胸膜凹陷征、血清AFP、CYFRA21-1、NSE水平均为孤立性肺结节性质影响因素(P<0.05)。结论 CT征象联合AFP、CYFRA21-1、NSE鉴别诊断孤立性肺结节性质,诊断效能较高,值得临床推广与应用。

Objective To explore the value of alpha-fetoprotein(AFP),cytokeratin 19 fragment(CYFRA21-1),neuron-specific enolase(NSE) and CT signs in distinguishing the nature of solitary pulmonary nodules.Methods A total of 206 patients with solitary pulmonary nodules in our hospital from January2019 to January 2021 were selected and divided into malignant group(n=103) and benign group(n=103) according to the nature of the nodule.Compare the levels of CT signs,AFP,CYFRA21-1,and NSE between the two groups,analyze the correlation between CT signs and AFP,CYFRA21-1,and NSE levels,draw receiver operating(ROC) curves,and evaluate AFP,CYFRA21-1,NSE And the value of CT signs in distinguishing the nature of solitary pulmonary nodules,and the relationship between CT signs,AFP,CYFRA21-1,NSE levels and the nature of solitary pulmonary nodules was analyzed.Results The ratio of burr sign,lobular sign,pleural indenlation sign and serum AFP,CYFRA21-1,NSE levels in the malignant group were higher than those in the benign group(P<0.05);correlation analysis showed that the CT signs and serum of patients with solitary lung malignant nodules AFP,CYFRA21-1,and NSE levels are related(P<0.05);ROC curve was drawn to evaluate the value of CT signs,serum AFP,CYFRA21-1,and NSE levels in the differential diagnosis of solitary pulmonary nodules,The diagnostic AUC is the largest and has good diagnostic performance.In Logistic regression analysis,it can be seen that the burr sign,lobular sign,pleural indentation sign,serum AFP,CYFRA21-1,and NSE levels are all influencing factors of the nature of solitary pulmonary nodules(P<0.05).Conclusion The combination of CT signs with AFP,CYFRA21-1,and NSE in differential diagnosis of solitary pulmonary nodules has high diagnostic efficiency and is worthy of clinical promotion and application.