MSCT参数、CA199、NSE在早期肺癌诊断及预后中的应用

Application of the multi-slice computer tomography parameters, CA199 and NSE in the diagnosis and prediction of the prognosis of early-stage lung cancer

目的探究多层螺旋CT(MSCT)参数、肿瘤相关抗原199(CA199)、神经特异性烯醇化酶(NSE)在早期肺癌诊断及预后中的应用价值。方法选取2017年5月至2021年4月早期肺癌患者90例作为观察组,另选取同期健康体检者50例作为对照组。比较2组MSCT参数、CA199、NSE水平,分析MSCT参数与CA199、NSE水平相关性,分析MSCT参数、CA199、NSE水平与早期肺癌的关系,绘制受试者工作特征(ROC)曲线,评价MSCT参数、CA199、NSE水平对早期肺癌的诊断价值,分析MSCT参数、CA199、NSE水平与早期肺癌临床分期的关系,分析早期肺癌患者预后情况。结果观察组肺容积差低于对照组,肺容积比、肺密度差、CA199、NSE水平高于对照组(P<0.05);早期肺癌患者MSCT参数肺容积差与CA199、NSE水平呈负相关关系,肺容积比、肺密度差与CA199、NSE水平呈正相关关系(P<0.05);MSCT参数肺容积差、肺容积比、肺密度差、CA199、NSE水平均为早期肺癌发病影响因素(P<0.05);绘制ROC曲线,评价MSCT参数、CA199、NSE水平对早期肺癌的诊断价值,发现MSCT参数肺容积差、肺容积比、肺密度差、CA199、NSE水平联合诊断AUC最大,具有良好诊断效能;早期肺癌患者MSCT参数肺容积差与临床分期呈负相关关系,肺容积比、肺密度差、CA199、NSE水平与临床分期呈正相关关系(P<0.05);早期肺癌患者根据MSCT参数、CA199、NSE平均值分为高水平组与低水平组,其中肺容积差高水平组3年预后不良率低于低水平组,肺容积比、肺密度差、CA199、NSE高水平组预后不良率高于低水平组(P<0.05)。结论早期肺癌患者MSCT参数肺容积差较低,肺容积比、肺密度差、CA199、NSE水平较高,临床检测其变化,可用于疾病早期诊断,且MSCT参数与CA199、NSE水平具有良好相关性,可为患者预后预测提供依据。

Objective To explore the application value of multi-slice spiral CT(MSCT)parameters,tumor-associated antigen 199(CA199),and neurospecific enolase(NSE)in the diagnosis and prediction of the prognosis of early-stage lung cancer.Methods A total of 90 patients with early-stage lung cancer admitted in our hospital from May 2017 to April 2021 were included as the observation group,and 50 healthy volunteers participating in physical examinations during the same period were included as the control group.MSCT parameters,CA199 and NSE levels between groups were compared,and their correlation were identified.Their correlations with the tumor staging of early-stage lung cancer were analyzed to elucidate their prognostic potentials.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic potentials of MSCT parameters,CA199 and NSE in early-stage lung cancer.Results The lung volume difference of the observation group was significantly lower than that of the control group,and the lung volume ratio,lung density difference,CA199 and NSE levels were significantly higher than those of the control group(all P<0.05).The lung volume difference in patients with early-stage lung cancer was negatively correlated with CA199 and NSE levels;and lung volume ratio and lung density difference were positively correlated with CA199 and NSE levels(all P<0.05).The lung volume difference,lung volume ratio,lung density difference,CA199,and NSE levels were risk factors for early-stage lung cancer(all P<0.05).The combination of lung volume difference,lung volume ratio,lung density difference,CA199,and NSE level yielded the largest area under the curve(AUC)in the diagnosis of early-stage lung cancer.The lung volume difference was negatively correlated with tumor staging of early-stage lung cancer;while lung volume ratio,lung density difference,CA199,and NSE levels were positively correlated with tumor staging(all P<0.05).Based on the cut-off values of MSCT parameters,CA199 and NSE,early-stage lung cancer patients were divided into high-level group and low-level group.The rate of 3-year poor prognosis in early-stage lung cancer patients with high level of lung volume difference was significantly lower than those with a low level,which,in early-stage lung cancer patients with high levels of lung volume ratio,lung density difference,CA199 and NSE was significantly higher than those with low levels(all P<0.05).Conclusion The lung volume difference in patients with early-stage lung cancer is relatively low,while the lung volume ratio,lung density difference,CA199 and NSE levels are relatively high.Clinical detection of their changes contributes to the early diagnosis of lung cancer.Moreover,MSCT parameters have a close correlation with CA199 and NSE,which provide references for predicting the prognosis of early-stage lung cancer.