低剂量CT与4肿瘤标记物联合检测对肺癌高危人群筛查的研究  

Low-dose spiral CT combined tumor markers for lung cancer screening high-risk groups

作　　者：李丰章 邹南安[1] 胡含明[1] 巫启恒 欧阳良[2] 

机构地区：[1]江西省萍乡市人民医院影像科,萍乡337055 [2]江西省萍乡市人民医院核医学科,萍乡337055

出　　处：《江西医药》2015年第5期384-387,共4页Jiangxi Medical Journal

摘　　要：目的评价低剂量螺旋CT(low dose spiral computed tomography,LDCT)扫描联合4种肺癌肿瘤标记物(人多效蛋白PTN、神经元特异烯醇化酶NSE、细胞角质蛋白Cyfra21-1及癌胚抗原CEA)检测对肺癌高危人群早期肺癌筛查的阳性率及特异性。方法分析及统计2011年-2013年进行LDCT扫描及肿瘤标志物联合筛查肺癌高危人群体的检查结果,并与常规早期肺癌筛查研究结果进行比较分析。结果 LDCT与常规剂量CT扫描肺部阳性检出率及病变影像学表现基本一致,无统计学差异(P>0.05),而辐射剂量明显下降,是常规剂量的6.38%(P<0.05);4种肺癌肿瘤标记物联合检测肺癌的敏感性约95%、特异性约80%,对诊断早期肺癌具有重要意义,4种肺癌肿瘤标记物对本实验组阳性率为1.58%(6例),最终确定早期肺癌的为1.05%(4例),LDCT在本实验组中检出病灶阳性率为12.1%(46例),其中8例影像诊断为早期肺癌(2.11%),最终仅4例(1.05%)确诊为早期肺癌,存在影像诊断假阳性。本研究共759人参与,其中LDCT和肿瘤标志物联合检测组(379例,女:176例,平均年龄54.3岁,慢阻肺患者7例;男:203,平均年龄57.6岁,慢阻肺患者26例)筛查肺部阳性率12.1%(46例有肺部CT阳性表现,6例肿瘤标记物联检均呈阳性,4例确诊为肺癌)。结论 LDCT与肺癌肿瘤标志物两种检查方法优势互补,早期肺癌检出率为1.05%,避免单项检查的假阳性事件发生,联合检测更有利于早期肺癌的早期发现及定性诊断。Objective To evaluate screening positive rate and specificity of low-dose spiral computed tomography （ LDCT） scanning joint 4 kinds of lung cancer tumor markers （multi-effect PTN,protein and neuron specific enzyme NSE,cell keratin pro-tein enolization Cyfra21-1 and carcinoembryonic antigen CEA） in detection of lung cancer at higher risk of early lung cancer. Methods Analysis and statistics of 2011-2013 LDCT scanning and lung cancer tumor markers combined screening high-risk group of test results,and comparing with conventional early lung cancer screening study result analysis. Results LDCT lung posi-tive detection rate with conventional dose CT scan imaging findings and pathological changes,no statistical difference（P〉0.05）,and radiation dose decreased obviously,it was regular doses of 6.38%（P〈0.05）;Four types of lung cancer tumor markers combined de-tection sensitivity about 95%,specificity about 80% of lung cancer,was of great significance for early diagnosis of lung cancer,4 kinds of this experimental lung cancer tumor markers positive rate was 1.58%（6 cases）,ultimately determine the early lung cancer was 1.05%（4 cases）,LDCT to detect lesions positive rate was 12.1%in this group （46 cases）,of which 8 cases of imaging diagnosis of early lung cancer （2.11%）,and finally only 4 cases （1.05%） diagnosed with lung cancer early,imaging in the diagnosis of false positives. To participate in this study,a total of 759 people,of whom LDCT and tumor markers combined test group（379,female：379 people,average age 54.3 years,7 patients with copd;male：203,the average age of 57.6 years,26 patients with copd screening lung were 12.1%（46 people with lung CT positive performance,6 people joint inspection tumor markers were positive,4 cases were diagnosed with lung cancer）. Conclusion LDCT two inspection methods and lung cancer tumor markers have complementary ad-vantages,early lung cancer detection rate was 1.05%,avoid single check false positive events,joint detection more conduciv

关 键 词：低剂量CT肿瘤标志物 联合 早期肺癌 筛查 

分 类 号：R734.2[医药卫生—肿瘤]