CT联合CEA、CA125对肺结核合并肺癌患者的临床诊断价值

Clinical Value of CT Combined with CEA and CA125 Detections in the Diagnosis of Pulmonary Tuberculosis with Lung Cancer

目的 分析CT联合癌胚抗原(CEA)、糖类抗原125 (CA125)对肺结核合并肺癌患者的临床诊断价值。方法 选取医院2018年1月至2019年12月收治的肺结核合并肺癌患者80例和肺结核患者80例,分为合并组和单纯组。两组患者均接受CT及CEA、CA125检查。结果 合并组患者CEA、CA125水平高于单纯组(P<0,05)。合并组患者肿块(47/80)、分叶征(49/80)、毛刺征(67/80)、胸腔积液(21/80)率高于单纯组(P<0.05),空洞征率9/80)低于单纯组(P<0.05)。周围型肺结核合并肺癌患者肿块(31/48)、分叶征(29/48)、毛刺征(26/48)、胸腔积液(15/48)率高于中心型肺结核合并肺癌组(P<0.05),空洞征率(2/48)低于中心型肺结核合并肺癌组(P<00.05)。CT、CEA、CA125及联合诊断的灵敏度、特异度及阳性率差异比较有统计学意义(P<0.05)。临床诊断价值:由低到高依次CEA、CA125、CT及联合诊断。结论 CT联合CEA、CA125诊断肺结核合并肺癌的临床价值较优,不仅能明确影像学特征,动态分析CT特征及CEA、CA125水平有利于指导临床制定个性化治疗方案,提升预后。

Objective To investigate the value of CT combined with carcinoembryonic antigen(CEA) and carbohydrate antigen 125(CA125) detections in the diagnosis of pulmonary tuberculosis with lung cancer.Methods 80 pulmonary tuberculosis patients with lung cancer(combined group) and 80 tuberculosis patients(simple group) in our hospital from January 2018 to December 2019 were enrolled.Both groups received CT,CEA,and CA125 examinations.Results CEA and CA125 levels were higher in the combined group than in the simple group(P<0.05).The rate of mass(47/80),lobulation sign(49/80),spiculation sign(67/80),and pleural effusion(21/80) in the combined group was higher than that in the simple group(P<0.05),and the rate of void signs(9/80) was lower than in the simple group(P<0.05).The rate of mass(31/48),lobulation sign(29/48),spiculation sign(26/48),and pleural effusion(15/48) in peripheral pulmona ry tuberculosis with lung ca ncer was higher than that in central pulmonary tuberculosis with lung cancer(P<0.05),and the rate of cavity sign(2/48) was lower than that in central pulmonary tuberculosis with lung cancer(P<0.05).The sensitivity,specificity and positive rate of CT,CEA,CA125 and combined detection had significant difference in the diagnosis of pulmonary tuberculosis with lung cancer(P<0.05),and the diagnostic value was the lowest in CEA,followed by CT and CA125,and was the highest in CT combined with CEA and CA125 examination.Conclusion CT combined with CEA and CA125 examinations can effectively show the imaging characteristics,moreover,the dynamic analysis of CT characteristics and CEA and CA125 levels can guide clinical treatment plans and improve the prognosis.