双源CT联合血清CYFRA21-1在肺结节良恶性鉴别诊断中的价值

Application value of dual-source CT combined with serum CYFRA21-1 in the differential diagnosis of benign and ma⁃lignant pulmonary nodules

目的探讨双源CT联合血清细胞角蛋白19片段抗原(CYFRA21-1)在肺结节良恶性鉴别诊断中的价值。方法选取106例肺结节患者的临床资料,根据病理结果将患者分为良性组32例和恶性组74例,均行双源CT检查以及血清CYFRA21-1水平检测,比较两组碘增加值(Overlay)、标准化碘含量(NIC)、能谱曲线斜率(K)及血清CYFRA21-1水平,分析其与肺结节良恶性的关系,并绘制受试者工作特征曲线(ROC)。结果恶性组Overlay、CYFRA21-1水平高于良性组,NIC、K低于良性组,Logistic回归分析证实双源CT检查参数Overlay、NIC、K以及血清CYFRA21-1均为恶性肺结节的独立影响因素(P<0.05);ROC分析显示Overlay、NIC、K、CYFRA21-1联合鉴别诊断与单独鉴别诊断相比较,联合诊断的曲线下面积(AUC)、特异度更高(AUC_(联合)0.914,AUC_(Overlay)0.607,AUC_(NIC)0.890,AUC_(K)0.763,AUC_(CYFRA21-1)0.898,特异度联合92.06%,特异度Overlay65.62%,特异度NIC=63.49%,特异度K71.87%,特异度CYFRA21-190.48%,P<0.05)。结论双源CT联合血清CYFRA21-1可提高对肺结节良恶性鉴别诊断的敏感度及特异度。

Objective To analyze the application value of dual-source CT combined with serum cytokeratin fragment antigen 21-1(CYFRA21-1)in the differential diagnosis of benign and malignant pulmonary nodules.Methods The medical records of 106 patients admitted to the hospital from January 2021 to April 2023 for pulmonary nodules were collected retrospectively.According to pathological results after resection,the patients were divided into benign group(n=32)and malignant group(n=74).All patients underwent dual-source CT examination and serum CYFRA21-1 level detection.The value added of iodine(Overlay),normalized iodine concentration(NIC),slope of energy spectrum curve(K),and serum CYFRA21-1 level were compared between the two groups.The we analyzed its relationship with benign and malignant pulmonary nodules and drew a receiver operating curve(ROC)curve to analyze its differential diagnostic value.Results Overlay and CYFRA21-1 level in the malignant group were higher than those in the benign group,while NIC and K were lower than those in the benign group(P<0.05).Logistic regression analysis confirmed that dual source CT examination parameters were overlain.NIC,K,and serum CYFRA21-1 were independent influencing factors for malignant pulmonary nodules.The ROC showed that the area under the curve(AUC)values and specificity of overlay,NIC and K combined with serum CYFRA21-1 level in the differential diagnosis of benign and malignant pulmonary nodules were higher than those of overlay,NIC,K or CYFRA21-1 level alone(AUC_(combined)0.914,AUC_(Over)lay0.607,AUC_(NIC)0.890,AUC_(K)0.763,AUC_(CYFRA)21-10.898,specificitycombined 92.06%,specificityOverlay65.62%,specificityNIC63.49%,specificityK71.87%,specificityCYFRA21-190.48%,P<0.05).Conclusion Dual-source CT combined with serum CYFRA21-1 can improve the differential diagnosis of benign and malignant pulmonary nodules.