高分辨CT增强扫描联合循环肿瘤细胞检测对磨玻璃样病变患者早期肺癌的诊断价值探究  

Diagnostic value of high resolution CT enhanced scan combined with cyclic tumor cell detection in early lung cancer with ground glass opacity

作　　者：黎小花 刘阿静 邢娟 张晓赞 宁沛雯[2] 颜辉 LI Xiao-hua;LIU A-jing;XING Juan;ZHANG Xiao-zan;NING Pei-wen;YAN Hui(Department of Clinical Laboratory,Shaanxi Maternal and Child Health Hospital,Xi'an 710061,China;Department of Clinical Laboratory,Xi'an Children's Hospital,Xi'an 710003,China;Department of Clinical Laboratory,Xi'an Central Hospital,Xi'an 710002,China)

机构地区：[1]陕西省妇幼保健院检验科,西安710061 [2]西安市儿童医院检验科,西安710003 [3]西安市中心医院检验科,西安710002

出　　处：《中国医学前沿杂志（电子版）》2018年第12期118-121,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨高分辨CT增强扫描联合循环肿瘤细胞(circulating tumor cell,CTC)检测对磨玻璃样病变(ground glass opacity,GGO)患者早期肺癌的诊断价值。方法选择西安市中心医院2015年1月至2017年12月经高分辨CT检查发现的GGO患者为研究对象,所有患者均经病理学检查确诊。采用飞利浦Brilliance 16排螺旋CT进行高分辨增强扫描,同时对所有患者进行CTC检测,分析良/恶性病变患者的CT征象,对比高分辨CT增强扫描、CTC检测及联合检查诊断早期肺癌的特异度、灵敏度、诊断符合率、阳性预测值、阴性预测值。结果 67例患者中41例为单纯GGO结节,26例为混合GGO结节;根据病理检查结果显示,67例患者中共有39例为恶性病变,28例为良性病变。恶性病变患者毛刺、分叶、胸膜凹陷征的CT征象的发生率均显著高于良性病变(P_均<0.05)。高分辨CT增强扫描诊断早期肺癌的灵敏度、特异度、诊断符合率、阳性预测值、阴性预测值均显著低于CTC检测及联合检查(P_均<0.05);联合检查的特异度、灵敏度、诊断符合率、阳性预测值、阴性预测值均高于CTC检测,但差异均无显著性(P_均> 0.05)。结论高分辨CT增强扫描和CTC检测对GGO均有较高的诊断价值,能有效鉴别病变的良/恶性,二者联合应用能显著提高诊断的特异度和灵敏度,为早期发现、诊断、治疗肺癌提供参考依据。Objective To investigate the diagnostic value of high resolution CT enhanced scan combined with circulating tumor cell(CTC)detection in early lung cancer with lung ground glass opacity(GGO).Method From January2015to December2017,67patients with GGO were examined by high resolution CT in Xi'an Central Hospital.All patients were confirmed by pathological examination.Phillips Brilliance16-slice spiral CT was used to perform high-resolution contrast-enhanced scan,and CTC was performed in all patients.The CT signs of benign and malignant lesions were analyzed.The specificity,sensitivity,diagnostic coincidence rate,positive predictive value and negative predictive value of high resolution CT,CTC and combined detection for early lung cancer were compared.Result In67cases,41cases of simple GGO lesion and26cases were mixed GGO lesions.According to the Result s of pathological examination,39cases were malignant and28cases were benign.The incidence of burr,lobulation and pleural indentation in malignant lesions was significantly higher than that in benign lesions(Pall<0.05).The specificity,sensitivity,diagnostic coincidence rate,positive predictive value and negative predictive value of high resolution CT were significantly lower than those of CTC detection and combined examination(Pall<0.05),and the indexes of combined examination were higher than those of CTC detection,but the differences were not significant(Pall>0.05).Conclusion High resolution CT enhanced scan and CTC detection are of high diagnostic value for GGO,and can effectively differentiate benign and malignant lesions.At the same time,the combination of the two Method can significantly improve the specificity and sensitivity of diagnosis,and provide a reference for early detection,diagnosis and treatment of lung cancer.

关 键 词：高分辨CT 循环肿瘤细胞 早期肺癌 磨玻璃样病变 诊断价值 

分 类 号：R734.2[医药卫生—肿瘤]