低剂量螺旋CT联合血清CEA、CYFRA21-1、NSE检测对早期肺癌的筛查价值

To explore the value of low-dose spiral CT combined with serum CEA, CYFRA21-1, and NSE in the screening of early lung cancer

目的分析低剂量螺旋CT联合血清血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)与细胞角蛋白片段抗原21-1(CYFRA21-1)检测对早期肺癌的筛查价值。方法选取河南省肿瘤医院2019年1月至2021年4月就诊的205例肺癌高危受检者进行研究,对所有患者使用低剂量螺旋CT检查、血清CEA、CYFRA21-1、NSE检测,并进行病理检查确诊,对比不同的筛查方法及联合诊断的灵敏度、准确度,分析低剂量螺旋CT联合血清CEA、CYFRA21-1、NSE检测对早期肺癌的筛查价值。结果病理活检诊断肺癌阳性患者68例,阴性患者137例;低剂量螺旋CT诊断灵敏度45.59%,特异度85.40%,准确度72.19%;血清CEA诊断灵敏度42.65%,特异度82.48%,准确度69.27%;血清CYFRA21-1诊断灵敏度66.17%,特异度86.13%,准确度79.51%;血清NSE诊断灵敏度57.35%,特异度84.67%,准确度75.61%;联合诊断灵敏度82.35%,特异度90.51%,准确度87.80%。结论低剂量螺旋CT联合血清CEA、CYFRA21-1、NSE检测结果灵敏度、特异度、准确度高,有利于早期肺癌的早诊断、早治疗,对降低肺癌死亡率有重大意义。

Objective To analyze the value of low-dose spiral CT combined with serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE) and cytokeratin fragment antigen 21-1(CYFRA21-1) in the screening of early lung cancer. Methods We selected 205 high-risk lung cancer patients from January 2019 to April 2021 in our unit for research. All patients were tested by low-dose spiral CT, serum CEA, CYFRA21-1, and NSE, and confirmed by pathological examination. Compare the sensitivity and accuracy of different screening methods and combined diagnosis, and analyze the value of low-dose spiral CT combined with serum CEA, CYFRA21-1, and NSE in the screening of early lung cancer. Results Pathological biopsy diagnosed 68 patients with positive lung cancer and 137 patients with negative;low-dose spiral CT had a diagnostic sensitivity of 45.59%, specificity of 85.40%,and accuracy of 72.19%;serum CEA had a diagnostic sensitivity of 42.65%, specificity of 82.48%, and accuracy of 69.27%;serum CYFRA21-1 diagnostic sensitivity 66.17%, specificity 86.13%, accuracy 79.51%;serum NSE diagnostic sensitivity 57.35%,specificity 84.67%, accuracy 75.61%;combined diagnostic sensitivity 82.35%, specificity 90.51%, accuracy 87.80%. Conclusion Low-dose spiral CT combined with serum CEA, CYFRA21-1, and NSE have high sensitivity, specificity, and accuracy. It is beneficial to the early diagnosis and treatment of early lung cancer, and is of great significance in reducing lung cancer mortality. It is worthy of screening in clinical lung cancer physical examination Promote in the investigation work.