多层螺旋CT联合血清CYFRA21-1、PCT、CA153及SCC水平在肺炎性结节与肺癌鉴别诊断中的价值分析

Value analysis of multi-slice spiral CT combined with serum CYFRA21-1,PCT,CA153 and SCC levels in the differential diagnosis of pneumogenic nodules and lung cancer

目的探讨多层螺旋CT联合血清细胞角蛋白19片段21-1(CYFRA21-1)、降钙素原(PCT)、血清糖类抗原153(CA153)及鳞状上皮细胞癌抗原(SCC)水平在肺炎性结节与肺癌鉴别诊断中的价值。方法选取我院2022年1月~2023年12月收治的符合条件的30例肺炎性结节患者(肺炎性结节组)及30例肺癌患者(肺癌组)作为研究对象,所有患者接受多层螺旋CT以及血清CYFRA21-1、PCT、CA153及SCC检测,比较两组患者的检查结果,并评估多层螺旋CT及血清CYFRA21-1、PCT、CA153、SCC单独检测与联合检测的诊断效能。结果肺癌组与肺炎性结节组病灶分叶征、毛刺、血管改变、结节分类、结节-肺界面存在显著差异,且肺癌组混合分叶或无分叶、无毛刺、血管改变、纯磨玻璃结节、结节-肺界面清晰的发生率显著高于肺炎性结节组(P<0.05)。肺癌组CYFRA21-1、CA153、SCC水平高于肺炎性结节组,PCT水平低于肺炎性结节组(P<0.05);联合检测的肺癌检出率显著高于多层螺旋CT、CYFRA21-1、CA153、SCC、PCT单独检测(P<0.05)。联合检测的灵敏度(96.67%)、特异度(96.67%)、准确度(96.67%)高于多层螺旋CT(73.33%、93.33%、83.33%)、血清CYFRA21-1(70.00%、83.33%、76.67%)、PCT(40.00%、93.33%、66.67%)、CA153(66.67%、93.33%、80.00%)及SCC(63.33%、83.33%、73.33%)单独检测。结论多层螺旋CT联合血清CYFRA21-1、PCT、CA153及SCC水平在肺炎性结节与肺癌鉴别诊断中效果较好,且具有较高的诊断效能。

Objective To investigate the value of multi-slice spiral CT(MSCT)combined with serum cytokeratin 19 fragment 21-1(CYFRA21-1),procalcitonin(PCT),serum sugar antigen 153(CA153)and squamous cell carcinoma antigen(SCC)levels in the differential diagnosis of pneumogenic nodules and lung cancer.Methods A total of 30 patients with pneumonia nodules(pneumonia nodule group)and 30 patients with lung cancer(lung cancer group)admitted to our hospital from January 2022 to December 2023 were selected as study objects.All patients received MSCT and CYFRA21-1,PCT,CA153 and SCC detection.The results of the two groups were compared,and the diagnostic efficacy of MSCT and serum CYFRA21-1,PCT,CA153,SCC detection alone and combined detection was evaluated.Results There were significant differences in lobular signs,spiculated margins,vascular changes,nodule classification,nodule pulmonary interface between the lung cancer group and the pneumonia nodule group.Moreover,the incidence of mixed lobulation or no lobulation,absence of spiculated margins,vascular changes,pure ground-glass nodules,and clear nodule-lung interface in the lung cancer group was significantly higher than that in the pneumonia nodule group(P<0.05).The levels of CYFRA21-1,CA153,SCC in the lung cancer group were higher than those in the pneumonia nodule group,and the PCT level was lower than that in the pneumonia nodule group(P<0.05).The detection rate of lung cancer by combined detection was significantly higher than that by MSCT,CYFRA21-1,CA153,SCC and PCT alone detection(P<0.05).The sensitivity(96.67%),specificity(96.67%)and accuracy(96.67%)of combined detection were higher than those of MSCT(73.33%,93.33%,83.33%),serum CYFRA21-1(70.00%,83.33%,76.67%),PCT(40.00%,93.33%,66.67%),CA153(66.67%,93.33%,80.00%)and SCC(63.33%,83.33%,73.33%).Conclusion MSCT combined with serum CYFRA21-1,PCT,CA153 and SCC levels is effective in the differential diagnosis of pneumogenic nodules and lung cancer,and has high diagnostic efficacy.