低剂量CT联合肿瘤标志物在孤立性肺结节性质诊断中的应用

Application of low-dose CT combined with tumor markers in the diag nosis of the solitary pulmonary nodule

目的 探究低剂量CT联合肿瘤标志物在孤立性肺结节(solitary pulmonary nodules, SPN)性质诊断的价值,分析SPN患者预后的影响因素。方法 选取SPN患者70例,均行低剂量CT检查、肿瘤标志物检查,对良恶性结节患者各标志物水平展开对比。结果 肺癌组神经元特异性烯醇化酶(neuron-specific enolase, NSE)、人多效蛋白(human pleiotrophin, PTN)、癌胚抗原(carcinoembryonic antigen, CEA)、甲胎蛋白(alpha fetoprotein, AFP)、细胞角蛋白19(cell Keratin 19,CYFRA21-1)、糖类抗原CA125(carbohydrate antigen 125)、鳞状上皮细胞癌抗原(squamous cell carcinoma antigen, SCCA)水平明显高于对照组(P<0.05)。低剂量CT联合血清肿瘤标志物在SPN性质判断中的效能更高。经对比,男性3年死亡率高于女性,年龄≥65岁者死亡率高于<65岁患者,肿瘤标志物至少1项为阳性者死亡率高于全部阴性的患者(均P<0.05)。结论 低剂量CT联合肿瘤标志物能够为SPN的性质判断提供重要信息,患者的预后,与性别、年龄、肿瘤标志物水平存在一定关联。

Objective To explore the value of low-dose CT combined with tumor markers in the diagnosis of solitary pulmonary nodules and analyzed the prognostic factors for patients.Methods A total of 70 patients with solitary pulmonary nodules were selected and examined by low-dose CT and tumor markers.The levels of markers with benign(control group)and malignant nodules were compared(lung cancer group).Results The levels of neuron-specific enolase(NSE),human pleiotrophin(PTN),carcinoembryonic antigen(CEA),alpha fetoprotein(AFP),cell keratin 19(CYFRA21-1),carbohydrate antigen 125 and squamous cell carcinoma antigen(SCCA)in the lung cancer group were significantly higher than those in the control group(P<0.05).Low-dose CT combined with serum tumor markers was more effective in judging the nature of solitary pulmonary nodules.By comparison,the mortality rate of men in 3 years was higher than that of women,and the mortality rate of those who were over 65 years old was higher than that of those who were under 65 years,and the mortality rate of those who were positive for at least one tumor marker was higher than that of those who were all negative(all P<0.05).Conclusion Low-dose CT combined with tumor markers can provide important information for judging the nature of solitary pulmonary nodules,and the prognosis of such patients is related to gender,age and tumor marker levels.