超声造影在肺周围型病变诊断中的价值及与血清肿瘤标志物的相关性分析

Analysis of value of contrast-enhanced ultrasound in the diagnosis of peripheral pulmonary lesions and its correlation with serum tumor markers

目的探讨超声造影在肺周围型病变诊断中的价值及与血清肿瘤标志物的相关性。方法回顾性选择2018年6月至2019年6月我院经影像学检查发现的73例肺周围型病变患者作为研究对象,均进行超声造影检查及组织活检,根据病变良恶性将其分为良性组与恶性组。比较两组的各项超声造影参数,并应用受试者工作特征(ROC)曲线分析超声造影参数对恶性肺周围型病变的诊断价值;均采用电化学发光法测定两组血清肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)水平,并比较各项肿瘤标志物水平。应用Spearman相关性分析恶性组中肿瘤标志物水平与超声造影参数的相关性。结果73例肺周围型病变患者中,恶性组的上升支斜率(RS)和峰值强度(PI)明显高于良性组,肺渡越时间(PTT)明显长于良性组,差异具有统计学意义(P<0.05),三者中PTT预测恶性组的AUC值最大,当PTT≥2.5 s时,预测灵敏度为81.1%,特异度为94.2%。恶性组的血清CEA、CA125、CYFRA21-1及NSE水平均高于良性组,差异具有统计学意义(P<0.05)。恶性组患者的超声造影参数中RS、PI、PTT与血清CEA、CA125、CYFRA21-1、NSE水平呈正相关(P<0.05)。结论超声造影能够评价肿瘤新生血管状态,更好地对肺周围型病变良恶性进行鉴别,且与血清肿瘤标志物的表达密切相关,具有重要的临床价值。

Objective To explore the value of contrast-enhanced ultrasound in the diagnosis of peripheral pulmonary lesions and its correlation with serum tumor markers.Methods A total of 73 patients with peripheral pulmonary lesions found by imaging examination in our hospital from June 2018 to June 2019 were retrospectively selected as study objects.All of them underwent contrast-enhanced ultrasonography examination and tissue biopsy.The patients were divided into benign group and malignant group according to the benign and malignant of lesions.The contrast-enhanced ultrasound parameters of the two groups were compared,and the diagnostic value of contrast-enhanced ultrasound parameters for malignant peripheral pulmonary lesions was analyzed by receiver operating characteristic(ROC)curve;serum tumor markers carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)and neuron specific enolase(NSE)levels of the two groups were measured by electrochemiluminescence,and the levels of tumor markers were compared.Spearman correlation was used to analyze the correlation between tumor markers levels and contrast-enhanced ultrasound parameters in the malignant group.Results Among 73 cases of peripheral pulmonary lesions,the ascending branch slope(RS)and peak intensity(PI)in the malignant group were significantly higher than those in the benign group,and the lung transit time(PTT)was significantly longer than that in the benign group,the differences were statistically signficant(P<0.05);among above three parameters,the AUC value of PTT in the malignant group was the largest,when the PTT was≥2.5 s,the prediction sensitivity was 81.1%,and the specificity was 94.2%.The levels of serum CEA,CA125,CYFRA21-1 and NSE in the malignant group were higher than those in the benign group,the differences were statistically signficant(P<0.05).In the malignant group,RS,PI and PTT were positively correlated with serum CEA,CA125,CYFRA21-1 and NSE levels(P<0.05).Conclusion Contrast-enhanced ultrasound can evaluate the state of tumor neovascularization,and better distinguish benign and malignant peripheral pulmonary lesions.It is closely related to the expression of serum tumor markers,which has important clinical value.