增强计算机断层扫描联合血清肿瘤标志物对肺癌的 诊断价值·

Diagnostic value of enhanced computed tomography combined with serum tumor markers in lung cancer

目的探讨增强计算机断层扫描(CT)联合血清肿瘤标志物对肺癌的诊断价值。方法选取2018年6月至2020年6月我院120例初筛疑似肺癌患者,均行增强CT,同时测定血清肿瘤标志物水平。分析病理诊断(穿刺活检或手术病理检查)结果;比较恶性、良性病变患者及不同病理类型肺癌患者的血清肿瘤标志物水平;以病理诊断为金标准,比较增强CT及血清肿瘤标志物单一及联合检测对肺癌的诊断效能;分析增强CT、血清肿瘤标志物单一及联合诊断结果与病理诊断结果的一致性。结果病理诊断结果显示,120例疑似肺癌患者中,65例为恶性病变,占54.17%,其中腺癌45例、鳞癌20例;55例为良性病变,占45.83%,其中肉芽肿样病变15例、支气管囊肿8例、肺部感染性病变32例。恶性病变患者的神经元特异性烯醇化酶、癌胚抗原、细胞角蛋白片段21-1水平高于良性病变患者,差异具有统计学意义(P<0.05)。腺癌患者的癌胚抗原水平高于鳞癌患者,细胞角蛋白片段21-1水平低于鳞癌患者,差异具有统计学意义(P<0.05)。以病理诊断为金标准,增强CT联合血清肿瘤标志物检测对肺癌的诊断灵敏度、准确度高于增强CT、神经元特异性烯醇化酶、癌胚抗原、细胞角蛋白片段21-1单一检测,差异具有统计学意义(P<0.05)。增强CT联合血清肿瘤标志物的诊断结果与病理诊断结果的一致性最高,Kappa值为0.762。结论增强CT联合血清肿瘤标志物对肺癌的诊断价值较高。

Objective To investigate the diagnostic value of enhanced computed tomography(CT)combined with serum tumor markers in lung cancer.Methods From June 2018 to June 2020,120 patients with preliminary screening of suspected lung cancer in our hospital were selected,all of them underwent enhanced CT,and the levels of serum tumor markers was measured at the same time.The pathological diagnosis(puncture biopsy or surgical pathological examination)results was analyzed;the levels of serum tumor markers in patients with malignant and benign lesions and patients with different pathological types of lung cancer were compared;taking pathological diagnosis as the gold standard,the diagnostic efficacy of single and combined detection of enhanced CT and serum tumor markers in lung cancer were compared;and the consistency between the single and combined enhanced CT and serum tumor markers diagnosis results and pathological diagnosis results was analyzed.Results Pathological diagnosis results showed that among 120 suspected lung cancer patients,65 cases were malignant lesions,accounting for 54.17%,including 45 cases of adenocarcinoma and 20 cases of squamous cell carcinoma;55 cases were benign lesions,accounting for 45.83%,including 15 cases of granulomatous lesions,8 cases of bronchial cysts,and 32 cases of pulmonary infectious lesions.The levels of neuron specific enolase,carcinoembryonic antigen and cytokeratin fragment 21-1 in patients with malignant lesions were higher than those in patients with benign lesions,and the differences were statistically significant(P<0.05).The level of carcinoembryonic antigen in patients with adenocarcinoma was higher than that in patients with squamous cell carcinoma,the level of cytokeratin fragment 21-1 was lower than that in patients with squamous cell carcinoma,and the differences were statistically significant(P<0.05).Taking pathological diagnosis as the gold standard,the sensitivity and accuracy of enhanced CT combined with serum tumor markers detection in the diagnosis of lung cancer were higher than those of enhanced CT,neuron specific enolase,carcinoembryonic antigen,cytokeratin fragment 21-1 single detection,and the differences were statistically significant(P<0.05).The consistency between the enhanced CT combined with serum tumor markers diagnosis results and pathological diagnosis results was the highest,and the Kappa value was 0.762.Conclusion Enhanced CT combined with serum tumor markers have high value in the diagnosis of lung cancer.