^99mTc-MIBI亲肿瘤显像联合ADAM-9、性激素检测在男性肺结节患者良恶性诊断中的敏感性与特异性探讨  

Sensitivity and specificity of ^(99m)Tc-MIBI imaging combined with ADAM-9,sex hormone in diagnosis of benign and malignant pulmonary nodules of males

作　　者：赵金彩 刘明霞[1] 袁有法 王庆胜 张金树[2] 

机构地区：[1]中国人民解放军第三0五医院放射科,北京100017 [2]中国人民解放军第三0五医院验科,北京100017

出　　处：《临床肺科杂志》2017年第12期2265-2270,共6页Journal of Clinical Pulmonary Medicine

摘　　要：目的探究^(99m)Tc-甲氧异丁基乙腈(^(99m)Tc-MIBI)亲肿瘤显像联合去整合素金属蛋白酶9(ADAM-9)、性激素检测在男性肺结节患者良恶性诊断中的敏感性与特异性。方法选择2014年12-2016年12月在我院接受CT检查发现肺部存在性质待定结节的78例男性患者作为本次研究对象,其中46例肺恶性结节患者作为恶性组,32例肺良性结节患者作为良性组,另选择男性健康者40例作为对照组,比较三组支气管肺泡灌洗液(BALF)中的ADAM-9 mRNA表达水平、BALF和血清中ADAM-9蛋白表达水平以及血清性激素水平,并分析9mTc-MIBI亲肿瘤显像联合ADAM-9、性激素检测用于男性肺结节患者良恶性诊断的阳性预测值、阴性预测值、准确性、特异性及灵敏性。结果恶性组患者BALF中的ADAM-9 mRNA表达水平以及BALF和血清中ADAM-9蛋白表达水平均显著高于对照组,而良性组患者上述各指标均显著低于对照组,数据差异具有统计学意义(P<0.05);恶性组患者雄激素、雌二醇及黄酮水平均显著低于对照组和良性组,差异均具有统计学意义(P<0.05);^(99m)Tc-MIBI亲肿瘤显像联合ADAM-9、性激素检测用于男性肺结节良恶性诊断,其阳性预测值、阴性预测值、准确性和灵敏性均显著优于^(99m)Tc-MIBI亲肿瘤显像或ADAM-9和性激素检测诊断方法,差异具有统计学意义(P<0.05)。结论^(99m)Tc-MIBI亲肿瘤显像联合ADAM-9、性激素检测在男性肺结节患者良恶性诊断中具有重要临床价值,其准确性、特异性与灵敏度均十分理想。Objective To explore the sensitivity and specificity of ^(99m)Tc-MIBI imaging combined with disintegrin and metalloproteinase-9( ADAM-9) and sex hormone in diagnosis of benign and malignant pulmonary nodules of males. Methods 78 male patients who were detected pulmonary nodules by computed tomography( CT) in our hospital from December 2014 to December 2016 were selected as research objects. 46 patients of malignant pulmonary nodules was the malignant group,32 patients of benign pulmonary nodules was the benign group,and 40 cases of male healthy as the control group. The ADAM-9 mRNA expression in bronchoalveolar lavage fluid( BALF),expression of ADAM-9 protein in BALF and serum,and serum sexual hormone level were compared in the three groups.The positive predictive value,negative predictive value,accuracy,specificity and sensitivity of ^(99m)Tc-MIBI imaging combined with ADAM-9,sex hormone in diagnosis of benign and malignant pulmonary nodules of males were analyzed. Results The expression of ADAM-9 mRNA in BALF and ADAM-9 protein in BALF and serum in the malignant group were significantly higher than those in the control group,and the benign group were significantly lower than the control group( P < 0. 05). The levels of male hormone,estradiol and flavone in the malignant group were significantly lower than those in the control group and the benign group( P < 0. 05). The positive predictive value,negative predictive value,accuracy and sensitivity of ^(99m)Tc-MIBI imaging combined with ADAM-9,sex hormone in diagnosis of benign and malignant pulmonary nodules of males were significantly better than the diagnosis of ^(99m)Tc-MIBI imaging or ADAM-9 and sex hormone detection( P < 0. 05). Conclusion ^(99m)Tc-MIBI imaging combined with ADAM-9 and sex hormone detection has great clinical significance in identifying pulmonary nodules of males. It's accuracy,sensitive and specify.

关 键 词：^99MTC-MIBI 去整合素金属蛋白酶9 性激素 肺结节 诊断 特异性 灵敏性 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]