肺癌与良性肿瘤不同放射诊断方法的比较分析

Comparative Analysis of Different Radiological Diagnostic Methods for Lung Cancer and Benign Tumors

目的比较CT和X线对肺癌与肺部良性肿瘤的诊断价值。方法选择2018年8月—2019年8月至河西学院附属张掖人民医院进行肺部肿物检查的278例患者进行临床研究,所有患者均分别给予胸部X线检查及CT检查。以病理检查结果为最终诊断结果,观察X线和CT检查诊断肺癌的诊断效能,比较两组患者的影像学表现特征检出率。对确诊为肺癌的患者,比较不同肺癌部位、不同组织病理学分类的检出率。结果278例患者中经病理检查最终有119例确诊为肺癌,CT检查的灵敏度、特异度、阳性预测值、阴性预测值分别为89.92%、93.08%、90.68%、92.50%,均高于X线检查的61.34%、67.30%、58.40%、69.93%,差异有统计学意义(χ^(2)=26.353、33.275、32.930、26.380,P<0.05);对278例患者进行肺部扫描后,CT检查出的存在毛刺或锯齿状、周围型孤立性结节状病灶、分叶征或边缘不规则影像学特征检出率均高于X线,差异有统计学意义(P<0.05),两种放射诊断方法对肺叶一侧或全肺不张的检出率对比,差异无统计学意义(P>0.05);在不同部位中,CT对周围型肺癌肺癌的检出率为51.26%,高于X线(32.77%),差异有统计学意义(P<0.05),对中央型肺癌两种检查方式检出率对比,差异无统计学意义(P>0.05);在不同组织病理学分类的肺癌中,CT对非小细胞肺癌的检出率为73.95%,高于X线(52.10%),差异有统计学意义(P<0.05),两种检查方式对小细胞肺癌检出率对比,差异无统计学意义(P>0.05)。结论在肺癌与肺良性肿瘤的诊断和鉴别诊断中,CT检查的优势更为明显。

Objective To compare the diagnostic value of CT and X-ray in lung cancer and benign lung tumor.Methods From August 2018 to August 2019,278 patients who came to Zhangye People's Hospital Affiliated to Hexi University for pulmonary tumor examination were selected for clinical research.All patients were given chest X-ray examination and CT examination respectively.Taking the pathological examination results as the final diagnosis results,the diagnostic efficacy of X-ray and CT examinations in diagnosing lung cancer was observed,and the detection rates of imaging features of the two groups of patients were compared.For patients diagnosed with lung cancer,the detection rates of different lung cancer sites and different histopathological classifications were compared.Results Among the 278 patients,119 were finally diagnosed with lung cancer by pathological examination.The sensitivity,specificity,positive predictive value and negative predictive value of CT examination were 89.92%,93.08%,90.68% and 92.50%,respectively.All were higher than 61.34%,67.30%,58.40% and 69.93% of X-ray examination,the difference was statistically significant(χ^(2)=26.353,33.275,32.930,26.380,P<0.05).After lung scans of 278 patients,the imaging features of spiculated or serrated,peripheral solitary nodular lesions,lobulation signs or irregular margins detected by CT were higher than those detected by X,the difference was statistically significant(P<0.05),there was no significant difference in the detection rate of atelectasis on one side of the lobe or the whole lung between the two radiological diagnostic methods(P>0.05).In different parts,the detection rate of CT for peripheral lung cancer was 51.26%,which was higher than that of X-ray(32.77%),the difference was statistically significant(P<0.05).There was no significant difference in the detection rate of central lung cancer between the two examination methods(P>0.05).Among the lung cancers of different histopathological classifications,the detection rate of CT for non-small cell lung cancer was 73.95%,which was higher than that of X-ray(52.10%),the difference was statistically significant(P<0.05).There was no significant difference in the detection rate of small cell lung cancer between the two methods.(P>0.05).Conclusion The advantages of CT examination are more obvious in the diagnosis and differential diagnosis of lung cancer and benign lung tumors.