PET/CT、支气管镜及联合肿瘤标记物在肺癌中的诊断价值

PET/CT and bronchoscope in association with tumor biomarkers in the diagnosis of lung cancer

目的探讨PET/CT、支气管镜及二者联合肿瘤标记物在肺癌中的诊断价值,减少肺癌的误诊率及漏诊率。方法回顾性分析2014年1月-2015年12月就诊于新疆医科大学第一附属医院诊断为肺部占位患者230例经胸膜、淋巴活检及病理确诊为原发性支气管癌患者156例临床资料。比较分析PET/CT影像学特点、支气管镜下表现及肿瘤标记物特点,总结肺癌的临床特征。结果病理诊断为肺癌的156例患者中,由PET/CT诊断为肺癌的有129例,符合病理诊断有102例,准确率为65.4%,灵敏度为68.5%,特异度为66.7%,漏诊率为31.5%;行支气管镜诊断为肺癌有97例,灵敏度为94.2%,特异度为80.2%,准确度为62.2%,漏诊率为5.8%;PET/CT联合支气管镜及肿瘤标记物诊断肺癌有145例,灵敏度为94.8%,准确度为100.0%,漏诊率5.2%。结论PET/CT联合支气管镜及肿瘤标记物诊断肺癌的准确率、灵敏度、特异度均高于单纯运用PET/CT或支气管镜,且漏诊率低于单纯运用PET/CT或支气管镜。

Objective To explore the diagnostic value of PET/CT,bronchoscope and both PET/CT and bronchoscope in association with tumor biomarkers in the diagnosis of lung cancer thereby reducing the misdiagnosis and missed diagnosis rate by retrospectively analysis of clinical manifestation,PET/CT,bronchoscopic manifestation and tumor biomarkers from 230 cases of patients with pulmonary occupying.Methods Collected were the clinic information from patients hospitalized in the First Affiliated Hospital of Xinjiang Medical University and analyzed and compared were the relevant PET/CT imaging features,bronchoscopic manifestation and tumor biomarkers to reduce the rate of misdiagnosis and missed diagnosis.Results Among 156 cases of patients pathologically diagnosed with lung cancer,diagnosis with lung cancer through PET/CT were 129 cases among which there were 102 cases were in line with pathologic diagnosis.The accuracy was 65.4%,sensitivity was 68.5%,specificity was 66.7%,missed diagnosis rate was 31.5%;diagnosis with lung cancer through bronchoscope were 97 cases whose sensitivity was 94.2%,specificity was 80.2%,accuracy was 62.2%,missed diagnosis rate was 5.8%;diagnosis with lung cancer through PET/CT and tumor biomarkers were 145 cases,whose sensitivity,accuracy and missed diagnosis was 94.8%,100% and 5.2%,respectively.Conclusion PET/CT in combination with bronchoscope and biomarkers was shown to be able to be superior to that of single use of PET/CT or bronchoscope,moreover its missed diagnosis was lower than that of single use of PET/CT or bronchoscope.