良恶性肺结节患者的CT影像学指标、血清学指标及呼出气体中VOCs的差异

Differences of CT Imaging Indexes,Serological Indicators and VOCs in Exhaled Gas in Patients between Benign and Malignant Pulmonary Nodules

本研究探讨肺恶性结节和良性结节患者的CT影像学指标、血清学指标及呼出气体中的挥发性有机化合物(VOCs)的差异。共纳入198例肺结节患者,其中120例肺癌患者(恶性结节组)和78例良性结节患者(良性结节组),对所有患者进行基于人工智能影像筛查系统的胸部CT检查。通过qRT-PCR法检测血清中miRNA-21-5p和miRNA-574-5p表达水平。采用ELISA法检测患者血清中的肿瘤标志物癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)水平。采用气相色谱质谱联用仪(GC-MS)分析患者呼出气体中的VOCs。结果显示,恶性结节组直径较良性结节组直径更长,恶性结节组出现毛刺征、气管征、血管征、空泡征和胸膜牵拉的比例远大于良性结节组(P<0.05)。恶性结节组的血清CYFRA21-1、NSE、CEA、miRNA-21-5p和miRNA-574-5p水平均高于良性结节组(P<0.05),恶性结节组呼出气体中的3-丙基甲苯、正丙苯、甲苯和B-柏木烯与良性结节组有显著差异(P<0.05)。本研究表明,肺恶性结节和良性结节患者的CT影像学指标、血清学指标及呼出气体中的VOCs存在差异,这三种检查手段的联合可能有利于肺癌的早期筛查和诊断。

This study investigated the differences between CT imaging indexes,serum blood indicators and volatile organic compounds(VOCs)in exhaled gas in patients with malignant and benign pulmonary nodules.198 patients with pulmonary nodules were included,including 120 patients with lung cancer(malignant nodule group)and 78 patients with benign nodule(benign nodule group),all patients underwent chest CT examination based on artificial intelligence imaging screening system.The expression levels of miRNA-21-5p and miRNA-574-5p in serum were detected by qRT-PCR.The levels of tumor markers carcinoembryonic antigen(CEA),neuron specific enolase(NSE)and cytokeratin 19 fragment(CYFRA21-1)in the serum of the patients were detected by ELISA kit.VOCs in exhaled breath of patients were analyzed by gas chromatography-mass spectrometry(GC-MS).The results showed that the diameter of the malignant nodule group was longer than that of the benign nodule group,and the proportion of burr sign,trachea sign,blood vessel sign,vacuole sign and pleural stretch in the malignant nodule group was much higher than that in the benign nodule group(P<0.05).The serum levels of CYFRA21-1,NSE,CEA,miRNA-21-5p and miRNA-574-5p in the malignant nodule group were higher than those in the benign nodule group(P<0.05).There were significant differences in toluene,n-propylbenzene,toluene and B-cedrene and benign nodule group between the malignant and benign nodule group(P<0.05).This study shows that there are differences in CT imaging indicators,serological indicators and VOCs in exhaled air between patients with malignant and benign pulmonary nodules,and the combination of these three examination methods may be beneficial to the early screening and diagnosis of lung cancer.