低剂量CT联合血清肿瘤标志物在早期非小细胞肺癌诊断中的应用价值

The Application Value of Low-dose CT Combined with Serum Tumor Markers in the Diagnosis of Early Non-small Cell Lung Cancer

目的 探讨低剂量CT(LDCT)联合血清肿瘤标志物在早期非小细胞肺癌(NSCLC)诊断中的临床价值。方法 选择2016年2月至2020年3月于广西壮族自治区龙潭医院接受筛查的疑似早期NSCLC患者(167例)为研究对象,收集患者的临床资料。以病理诊断为“金标准”,早期NSCLC137例,良性病变30例。结果 早期NSCLC的影像学特征多样,以实性病变为主,其次为部分实性结节,少见非实性结节病变。与良性病变患者相比,早期NSCLC患者血清癌胚抗原(CEA)、细胞角蛋白片段21-1(CYFRA21-1)及神经元特异性烯醇化酶(N S E)水平均更高(P<0.05)。LDCT联合血清肿瘤标志物诊断Kappa系数大于LDCT检查和肿瘤标志物检测,跟病理诊断结果的一致性最强(P<0.05)。LDCT联合血清肿瘤标志物诊断的准确度和敏感度高于LDCT检查和肿瘤标志物检测,差异均有统计学意义(P<0.05)。结论 LDCT联合血清肿瘤标志物可明显提高早期NSCLC诊断的敏感度、准确度以及跟病理确诊结果的一致性,有效减少误诊、漏诊,值得临床上推广使用。

Objective To investigate the clinical value of low-dose CT(LDCT) combined with serum tumor markers in the early diagnosis of non-small cell lung cancer(NSCLC). Methods The patients with suspected early NSCLC(167 cases) who were screened in Guangxi Zhuang Autonomous Region Longtan Hospital from February 2016 to March 2020 were selected as the research objects,and the clinical data of patients were collected. Pathological diagnosis was the “gold standard”,and there were 137 cases early NSCLC and 30 cases benign lesions. Results Early NSCLC has a variety of imaging features,mainly solid lesions,followed by partial solid nodules,rare non-solid nodular lesions. Compared with patients with benign lesions,patients with early NSCLC had higher serum carcinoembryonic antigen(CEA),cytokeratin fragment 21-1(CYFRA21-1) and neuronspecific enolase(NSE) levels(P<0.05). The Kappa coefficient in diagnosis of LDCT combined with serum tumor markers was higher than that in diagnosis of LDCT and tumor markers,and the consistency with pathological diagnosis was the strongest(P<0.05). The accuracy and sensitivity of LDCT combined with serum tumor markers were higher than that of LDCT and tumor markers,and the difference was statistically significant(P<0.05). Conclusion LDCT combined with serum tumor markers can significantly improve the sensitivity and accuracy of early NSCLC diagnosis and the consistency with pathological diagnosis results,effectively reduce misdiagnosis and missed diagnosis,which is worthy of clinical promotion.