胸部CT联合肿瘤标志物对早期老年人肺癌的诊断价值  

Diagnostic value of thoracic CT combined with tumor markers in the elderly patients with early lung cancer

作　　者：周舟[1] 王道清[1] Zhou Zhou;Wang Daoqing(Department of Radiology, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Chin)

机构地区：[1]河南中医药大学第一附属医院放射科,郑州450000

出　　处：《中华老年医学杂志》2018年第5期536-538,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨胸部CT检查联合血清肿瘤标志物[癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段（Cyfra21—1）、鳞状细胞癌相关抗原（SCC-Ag）]检测对早期老年人肺癌的诊断价值。方法随机选择经穿刺或手术确诊的肺癌患者60例（肺癌组，肺癌临床分期为Ⅰa～Ⅲa期），良性病变84例（良性组），同期正常体检患者68例（正常组），对所有患者的胸部CT征象及血清肿瘤标志物水平进行回顾性分析。结果肺癌组CEA、NSE、Cyfra21—1、SCC-Ag血清浓度均高于良性组与正常组（P分别=0．0247、0．0319、0．0198、0．0384）；肺癌组不同直径大小与肿瘤标志物表达的阳性率总体上有显著性差异（x^2=81．09，P=0．00125），且随直径增加阳性率增加；〉2cm且≤3cm组与〉3cm组比较差异有显著性（x^2=6．810，P=0．00784）；胸部CT诊断肺癌的敏感度85．0%、特异度55．9％、阳性预测值43．2％、阴性预测值90．4％；胸部CT联合肿瘤标志物检测能获得较高的灵敏度95．0％与特异度86．8％及阴性预测值97．8％。结论胸部CT联合血清肿瘤标志物检测有助于提高早期老年肺癌（尤其是肿瘤直径〉3cm）的准确诊断。Objectives To investigate the diagnostic value of thoracic CT combined with tumor markers of carcinoembryonic antigen （CEA）, neuron-specific enolase （NSE）, cyfra21-1, and squamous cell careinoma-antigen（SCC Ag）in the elderly patients with early lung cancer. Methods Two hundreds and twelve elderly subjects were divided into 3 groups： a lung cancer group （stageⅠa-Ⅲ a, n = 60）diagnosed by pathological findings of puncture-or postsurgical-tissue, a benign group（n= 84）with pathology-diagnosed benign lesions and a normal control group（n= 68）with normal health examination. The chest CT signs and levels of serum tumor markers of the 212 individuals were retrospectively analyzed. Results The serum levels of CEA, NSE, eyfra21-1, and SCC-Ag were higher in the lung cancer group than in the benign group and the normal group（ P= 0. 0247, 0. 0319,019,0. 0384, respectively）. The positive rate of tumor marker was increased along with the increased lung cancer diameter. The lung cancer diameter 〈1 cm, 1-1.9 cm, 2-2.9 cm,〉3 cm of four groups showed that the positive rate[-case（ %）]of tumor marker was 1（16.7） ,5（38.5）, 11 （ 64. 7）, 23 （95.8）, respectively, with a significantly difference in total 4 groups（ x^2 = 81.09, P= 0. 00125） and between diameter 2 2. 9 cm and 〉3 cm groups（k3 =6. 810, P=0. 00784）. The sensitivity of chest CT in diagnosis of lung cancer was 85.0%, specificity 55.9%, positive predictive value 43.2%, and negative predictive value 90. 4 %. A higher sensitivity of chest CT combined with tumor markers in diagnosis of lung cancer was 95.0%, a higher specificity 86.8%, and a higher negative predictive value 97.8%. Conclusions The detection of chest CT combined with serum tumor markers is helpful to improve the accuracy of diagnosis in elderly patients with early lung cancer, espeeially when the diameter of tumor is 3 cm.

关 键 词：肿瘤标记 生物学 肺癌 早期诊断 

分 类 号：R734.2[医药卫生—肿瘤]