64排CT联合血清学检查对非小细胞性肺癌纵隔淋巴结转移的诊断

Diagnosis Effects of 64-Slice CT Joint Serology on Non-small Cell Lung Cancer with Mediastinal Lymph Node Metastasis

目的评价64排CT联合血清学检查对非小细胞性肺癌纵隔淋巴结转移的诊断意义.方法选择非小细胞肺癌患者72例(A组)及同期行健康体检的40例研究对象为对照组(B组),分别检测各组肺癌灌注参数、MMP-9、TIMP-1、CEA、CYFRA21-1水平并对CT及血清学检测的效能进行分析.结果 N1期BF及PS值显著大于N0期(P<0.05),N2期BF、BV、PS显著高于N0期及N1期(P<0.05).A组N0期患者CEA、CYFRA21-1、MMP-9、TIMP-1较B组有显著变化(P<0.05),N1期患者CEA、CYFRA21-1、MMP-9、TIMP-1较B组及N0期有显著变化(P<0.05),N2期患者CEA、CYFRA21-1、MMP-9、TIMP-1较B组及N0期、N1期患者有显著性差异(P<0.05).A组淋巴结转移1~2个患者CEA、CYFRA21-1、MMP-9、TIMP-1较B组有显著变化(P<0.05),淋巴结转移3~6个患者CEA、CYFRA21-1、MMP-9较B组及淋巴结转移1~2个期有显著变化(P<0.05),淋巴结转移≥7个患者CEA、CYFRA21-1、MMP-9、TIMP-1较B组及淋巴结转移1~2个、淋巴结转移3~6个患者有显著性差异(P<0.05).采用CEA+CYFRA21-1+MMP-9+TIMP-1对72例患者进行诊断,准确性为69.42%,单一采用CT进行诊断,准确性为89.26%,采用CEA+CYFRA21-1+MMP-9+TIMP-1与CT对纵隔淋巴结转移患者诊断准确性为93.07.结论采用CT及血清学联合检测有助于提高对肺癌淋巴结转移的诊断效能.

Objective The purpose of this study was to evaluate diagnosis effects of 64-slice CT joint serology on non-small cell lung cancer with mediastinal lymph node metastasis. Methods Seventy-two patients with non-small cell lung cancer(Group A) and 40 healthy cases as the control group(Group B) were enrolled. MMP-9,TIMP-1,CEA and CYFRA21-1 levels were detected and the effectiveness of CT and serological testing were analyzed. Res ults BF and PS values in stage N1 were significantly larger than those in N0 stage(P<0.05), and BF,BV and PS of N2 were significantly higher than those of N0 and N1 stages(P< 0.05). Compared with Group B,there were significant changes of CEA, CYFRA21-1,MMP-9 and TIMP-1 in N0,N1 and N2 patients of Group A(P<0.05). In Group A, the changes of CEA,CYFRA21-1,MMP-9 and TIMP-1 in N1 patients were more significant than those in N0 patients(P<0.05), and those in N2 patients were more significant than those in N0 and N1 stages(P <0.05). Compared with Group B, there were significant changes of CEA, CYFRA21-1, MMP-9 and TIMP-1 in patients with lymph node metastasis of Group A(P<0.05). There were significant differences in CEA,CYFRA21-1 and MMP-9 among patients with lymph node metastasis of 1-2, 3-6 and≥ 7(P<0.05),and there was significant difference in TIMP-1 between patients with lymph node metastasis of 3-6 and≥ 7(P<0.05). Using CEA + CYFRA21-1 + MMP-9 + TIMP-1,the diagnostic accuracy was 69.42% in 72 patients, and the accuracy of a single diagnosis using CT was 89.26%. However,the diagnostic accuracy was 93.07% in patients with mediastinal lymph node metastasis by using CEA + CYFRA21-1 + MMP-9 + TIMP-1 and CT combination. Conclus ion CT and serology for detection of lymph node metastasis of lung cancer can help improve diagnostic performance.