增强双期CT成像参数联合血清癌胚抗原对肺亚厘米结节良恶性的预测价值

Predictive value of enhanced dual-phase CT imaging parameters combined with serum carcinoembryonic antigen for benign and malignant pulmonary subcentimeter nodules

目的探讨增强双期CT成像参数联合血清癌胚抗原(CEA)表达预测肺亚厘米结节良恶性的价值。方法回顾性分析安徽省宣城市中心医院2018年3月至2022年5月就诊的69例肺亚厘米结节患者的临床资料,以病理结果分为良性组(46例)与恶性组(23例)。比较两组增强双期CT成像参数与入院时血清CEA表达水平;分析肺亚厘米结节良恶性的影响因素;受试者操作特征曲线预测增强双期CT成像参数联合血清CEA表达对肺亚厘米结节良恶性的诊断价值。结果恶性组结节边界清楚占比低于良性组;分叶征、胸腺凹陷征、磨玻璃密度、毛刺、上叶、血管集束征、空泡征占比高于良性组(P<0.05)。恶性组血清CEA阳性表达率高于良性组(P<0.05)。结节边界、分叶征、磨玻璃密度、毛刺为肺亚厘米结节恶性的影响因素(OR>1,P<0.05)。增强双期CT成像参数预测肺亚厘米结节良恶性模型为Log(P)=1.325+1.543×结节边界+1.265×分叶征+1.421×磨玻璃密度+1.172×毛刺。增强双期CT成像参数预测模型及血清CEA表达预测肺亚厘米结节恶性曲线下面积值高于各项单独检测。结论增强双期CT成像参数、血清CEA表达可用于预测肺亚厘米结节良恶性,且二者联合具有更高的预测价值。

Objective To investigate the value of enhanced dual-phase CT imaging parameters combined with serum carcinoembryonic antigen(CEA)expression in predicting benign and malignant pulmonary subcentimeter nodules.Methods The clinical data of 69 patients with pulmonary subcentimeter nodules admitted to Xuancheng Central Hospital of Anhui Province from March 2018 to May 2022 were retrospectively analyzed.According to pathological results,they were divided into benign group(46 cases)and malignant group(23 cases).The enhanced dual-phase CT imaging parameters and the serum CEA expression level at admission were compared between two groups;and the influencing factors of benign and malignant pulmonary subcentimeter nodules were analyzed;predictive value of enhanced dual-phase CT imaging parameters combined with serum CEA expression in the diagnosis of benign and malignant pulmonary subcentimeter nodules by receiver operating characteristic curve.Results The proportion of clear tubercle boundary in malignant group was lower than that in benign group;the proportion of foliation sign,thymus sag sign,ground glass density,burr,upper lobe,vascular cluster sign,and vacuole were higher than those in benign group(P<0.05).The positive expression rate of CEA in malignant group was higher than that in benign group(P<0.05).The nodular boundary,foliation,ground glass density,and burr were the factors affecting the malignant pulmonary subcentimeter nodules(OR>1,P<0.05).The benign and malignant model of pulmonary subcentimeter nodules predicted by enhanced dual-phase CT imaging parameters was Log(P)=1.325+1.543×nodular boundary+1.265×foliation+1.421×ground glass density+1.172×burr.The value of area under the curve of malignant pulmonary subcentimeter nodules predicted by enhanced dual-phase CT imaging parameter prediction model and serum CEA expression was higher than that of each single test.Conclusion Enhanced dual-phase CT imaging parameters and serum CEA expression have important value in predicting benign and malignant pulmonary subcentimeter nodules,and their combination has higher value.