低剂量多层螺旋CT联合肿瘤标记物ProGRP和CEA及CYFRA21-1对肺癌的诊断价值

Value of low-dose multi-slice spiral CT combined with tumor markers ProGRP,CEA and CYFRA21-1 in the diagnosis of lung cancer

目的:探讨低剂量多层螺旋CT(LDCT)联合肿瘤标记物胃泌素释放肽前提(ProGRP)、癌胚抗原(CEA)及细胞角蛋白19片段(CYFRA21-1)对肺癌的诊断价值。方法:选取2020年1月—2022年1月枣庄市台儿庄区中医院收治的96例疑似肺癌患者为研究对象,均行LDCT及血清ProGRP、CEA及CYFRA21-1检测,以病理诊断结果为金标准,分析LDCT联合ProGRP、CEA及CYFRA21-1检测对肺癌的诊断效能。结果:以病理诊断结果为金标准,DCE-MRI诊断肺癌的准确率、灵敏度、特异度分别为82.29%、85.48%、76.47%。肺癌组LDCT征象以直径≥3 c m、边界不清的部分实性结节为主,且多伴有分叶征、毛刺征及胸膜凹陷征。肺癌组血清ProGRP、CEA及CYFRA21-1水平均高于肺良性病变组(P<0.05)。ROC曲线分析显示,LDCT联合ProGRP、CEA、CYFRA21-1诊断肺癌的AUC为0.928,灵敏度为87.1%,特异度为94.1%,均高于各项单独检测。结论:LDCT联合肿瘤标记物ProGRP、CEA及CYFRA21-1能提高肺癌的诊断效能。

Objective To investigate the diagnostic value of low-dose multi-slice spiral CT(LDCT)combined with gastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA)and cytokeratin 19 fragment(CYFRA21-1)in lung cancer.Methods A total of 96 suspected lung cancer patients admitted to Taierzhuang District Hospital of Traditional Chinese Medicine in Zaozhuang City from January 2020 to January 2022 were selected as the study objects.LDCT and serum ProGRP,CEA and CYFRA21-1 determination were performed,and pathological diagnosis results were used as the gold standard.To analyze the diagnostic efficiency of LDCT combined with ProGRP,CEA and CYFRA21-1 in lung cancer.Results With pathological diagnosis as the gold standard,the accuracy,sensitivity and specificity of DCE-MRI in the diagnosis of lung cancer were 82.29%,85.48%and 76.47%respectively.LDCT signs in lung cancer group were mainly partial solid nodules with diameter≥3cm and unclear boundary,and were often accompanied by lobectomy sign,burr sign,air bronchial sign,pleural sag sign and mediastinal lymph node enlargement.The levels of serum ProGRP,CEA and CYFRA21-1 in lung cancer group were higher than those in lung benign lesion group(P<0.05).ROC curve analysis showed that the AUC of LDCT combined with ProGRP,CEA and CYFRA21-1 in the diagnosis of lung cancer was 0.928,the sensitivity was 87.1%and the specificity was 94.1%,which were higher than those of each single assay.Conclusion LDCT combined with ProGRP,CEA and CYFRA21-1 can improve the diagnostic efficiency of lung cancer.