MRI联合CEA、CYFRA21-1检测对早期肺癌的诊断价值

The Diagnostic Value of MRI Combined with CEA and CYFRA21-1 in Early Lung Cancer

目的分析磁共振成像(MRI)联合癌胚抗原(CEA)、胞角蛋白19片段抗原2l-1(CYFRA21-1)用于早期肺癌的临床诊断价值。方法选取2018年4月到2020年11月我院疑似早期肺癌患者69例作为研究对象,均行MRI、CEA、CYFRA21-1检测。以病理学检测为“金标准”。统计MRI、CEA、CYFRA21-1单独检测和三者联合诊断的诊断结果、诊断效能,对比不同病理结果血清CEA、CYFRA21-1水平、不同病理类型血清CEA、CYFRA21-1水平、不同影像学特征血清CYFRA21-1水平。结果本组69例疑似早期肺癌患者,病理学检查确诊阳性35例,阴性34例;MRI诊断出真阳性、真阴性分别为28例、27例;CEA诊断出真阳性、真阴性分别为23例、29例;CYFRA21-1诊断出真阳性、真阴性均为22例、22例;三者联合诊断真阳性、真阴性分别为32例、30例。三者联合诊断灵敏度91.43%、准确度89.86%均明显高于MRI 80.00%、79.71%,CEA 65.71%、75.36%,CYFRA21-162.86%、63.77%(P<0.05)。肺癌患者血清CEA、CYFRA21-1水平明显高于非肺癌患者(P<0.05);鳞癌患者血清CEA、CYFRA21-1水平明显高于腺癌患者、小细胞肺癌(P<0.05);存在淋巴结转移、病灶>3cm、存在分叶征的血清CYFRA21-1水平者明显高于无淋巴结转移、病灶≤3cm、无分叶征者(P<0.05)。结论MRI联合CEA、CYFRA21-1检测早期肺癌可提高诊断灵敏度与准确度,可用于临床评估病理类型,且不同影像学特征CYFRA21-1表达存在显著差异,可为疾病确诊提供更客观、全面的信息支持。

Objective To analyze the clinical diagnostic value of magnetic resonance imaging(MRI)combined with carcinoembryonic antigen(CEAEA)and cytokeratin 19 fragment antigen 2l-1(CYFRA21-1)in early lung cancer.Methods A total of 69 patients with suspected early-stage lung cancer in our hospital from April 2018 to November 2020 were selected as the research objects,and they were all tested by MRI,CEAEA,and CYFRA21-1.Pathological examination was regarded as the"gold standard".The diagnostic results and efficacy of MRI,CEAEA and CYFRA21-1 alone and the combined diagnosis were statistically analyzed.Serum CEAEA and CYFRA21-1 levels were compared with different pathological results,with different pathological types,and with different imaging features.Results Among 69 patients suspected of early stage lung cancer,35 were positive and 34 were negative.True positive and true negative results of MRI were 28 cases and 27 cases respectively.True positive and true negative CEAEA were found in 23 and 29 cases respectively.There were 22 true positive and 22 true negative cases diagnosed with CYFRA21-1.The true positive and true negative cases were 32 and 30 cases respectively.The combined diagnostic sensitivity of 91.43%and accuracy of 89.86%were significantly higher than those of MRI 80.00%and 79.71%,CEAEA 65.71%and 75.36%,CYFRA21-162.86%and 63.77%(P<0.05).Serum CEAEA and CYFRA21-1 levels in lung cancer patients were higher than those in non-lung cancer patients(P<0.05).Serum CEAEA and CYFRA21-1 levels in squamous cell carcinoma patients were higher than those in adenocarcinoma patients and small cell lung cancer patients(P<0.05).The serum CYFRA21-1 level in patients with lymph node metastasis,lesions>3cm,and lobulation sign was higher than that in patients without lymph node metastasis,lesions≤3cm,and no lobulation sign(P<0.05).Conclusions MRI combined with CEAEA and CYFRA21-1 in the detection of early lung cancer can improve the diagnostic sensitivity and accuracy,and can be used for clinical evaluation of pathological types.Moreover,the expression of CYFRA21-1 is significantly different in different imaging features,which can provide more objective and comprehensive information support for the diagnosis of the disease.