多层螺旋CT联合血清ChEα-HBDH PGRN对肺结核合并肺癌的诊断价值

Diagnostic Value of Multi-Slice Spiral CT Combined with Serum ChEα-HBDH and PGRN for Pulmonary Tuberculosis Combined with Lung Cancer

目的:探究多层螺旋CT联合血清胆碱酯酶(ChE)、α-羟丁酸脱氢酶(α-HBDH)、颗粒蛋白前体(PGRN)对肺结核合并肺癌的诊断价值。方法:选取2021年6月至2023年6月本院收治的84例肺结核患者,其中经过病理检测确诊为肺结核合并肺癌患者36例即为研究组,单纯肺结核患者48例为对照组。患者均进行多层螺旋CT检测。采用酶联免疫吸附试验(ELISA)法检测血清中ChE、α-HBDH、PGRN表达水平。ROC曲线分析多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌的诊断价值。结果:研究组肿块、胸膜凹陷征、分叶征、胸腔积液、毛刺征、结节影占比显著高于对照组(P<0.05)。与对照组相比,研究组患者血清中ChE水平显著降低,α-HBDH、PGRN水平显著升高(P<0.05)。与单独诊断相比,多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌诊断的AUC显著升高(z=3.497,P=0.001;z=4.310,P<0.001;z=3.328,P=0.001;z=4.518,P<0.001)。结论:肺结核合并肺癌患者血清ChE低表达,α-HBDH、PGRN高表达,多层螺旋CT联合血清ChE、α-HBDH、PGRN对肺结核合并肺癌具有较高诊断价值。

Objective:To explore the diagnostic value of multi-slice spiral CT combined with serum cholinesterase(ChE),α-hydroxybutyrate dehydrogenase(α-HBDH),and progranulin(PGRN)in the diagnosis of pulmonary tuberculosis combined with lung cancer.Methods:From June 2021 to June 2023,84 patients with pulmonary tuberculosis accepted by our hospital were collected.Among them,36 patients diagnosed with pulmonary tuberculosis combined with lung cancer through pathological examination were made the test group,and 48 patients with simple pulmonary tuberculosis were made the control group.All patients underwent multi-slice spiral CT examination.Enzyme-linked immunosorbent assay(ELISA)was applied to detect the expression levels of ChE,α-HBDH,and PGRN in serum.ROC curve was applied to analyze the diagnostic value of multi-slice spiral CT combined with serum ChE,α-HBDH,and PGRN for pulmonary tuberculosis combined with lung cancer.Results:The proportions of masses,pleural indentation sign,lobulation sign,pleural effusion,spiculation,and nodular shadow sign in the test group were higher than those in the control group(P<0.05).Compared with the control group,the serum ChE level in the test group was reduced,whileα-HBDH and PGRN levels were increased(P<0.05).Compared with individual diagnosis,the combination of multi-slice spiral CT and serum ChE,α-HBDH,and PGRN had a higher AUC in the diagnosis of pulmonary tuberculosis combined with lung cancer(z=3.497,P=0.001;z=4.310,P<0.001;z=3.328,P=0.001;z=4.518,P<0.001).Conclusion:Serum ChE expression is low,and theα-HBDH and PGRN expression is high in patients with pulmonary tuberculosis combined with lung cancer.Multi-slice spiral CT combined with serum ChE,α-HBDH,and PGRN has a high diagnostic value for pulmonary tuberculosis combined with lung cancer.