SPECT骨显像联合血清CYFRA21-1、CEA诊断NSCLC患者骨转移的临床价值分析  

Clinical Value of SPECT Bone Imaging Combined with Serum CYFRA21-1 and CEA in the Diagnosis of Bone Metastasis in Patients with NSCLC

作　　者：尚大雷[1] 陈书成[1] SHANG Da-lei;CHEN Shu-cheng(Department of Clinical Laboratory,People's Hospital of Beijing Daxing District,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院检验科,北京102600

出　　处：《中国CT和MRI杂志》2020年第5期139-142,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨单光子发射型计算机断层扫描(SPECT)全身骨显像联合血清角蛋白片段19(CYFRA21-1)和癌胚抗原(CA125)诊断非小细胞肺癌(NSCLC)骨转移的临床价值。方法选取2016年3月~2018年7月在本院诊治的原发性NSCLC患者106例为研究对象,伴骨转移者62例,未发生骨转移44例。回顾性分析骨转移患者SPECT骨显像,血清CYFRA21-1、CA125检查结果,分析不同类型NSCLC骨转移发生率,骨转移分布情况,骨转移Soloway分级与CYFRA21-1、CEA水平间的关系,SPECT骨显像、CYFRA21-1、CEA单独诊断及联合诊断效能。结果 NSCLC骨转移发生率为58.59%,腺癌骨转移发生率(64.62%)显著高于鳞癌骨转移发生率(48.78%)(P<0.05);骨转移最常见于肋骨(占59.68%),其次为脊柱(占51.61%);经Spearman相关分析,CYFRA21-1、CEA水平与骨转移分级呈正相关(r=0.317,r=0.574,P均<0.05);经受试者工作特征曲线(ROC)分析,SPECT骨显像联合CYFRA21-1、CEA诊断曲线下面积(AUC)为0.917,高于各单项检查指标。结论相对于单独指标诊断,SPECT骨显像联合血清CYFRA21-1、CEA能更有助于NSCLC患者骨转移的检出。Objective To investigate the clinical value of single-photon emission computed tomography(SPECT) whole body bone imaging combined with serum eytokeratin-19-fragment(CYFRA21-1) and carbohydrate antigen 125(CA125) in the diagnosis of bone metastasis in patients with non-small cell lung cancer(NSCLC). Methods 106 patients with primary NSCLC who were diagnosed and treated in the hospital from March 2016 to July 2018 were enrolled in the study, including 62 patients with bone metastases and 44 patients without. SPECT bone imaging of patients with bone metastases and examination results of serum CYFRA21-1 and CA125 were retrospectively analyzed. The incidence and distribution of bone metastasis in different types of NSCLC, the relationship between Soloway classification of bone metastases and levels of CYFRA21-1 and CEA levels, efficiencies of alone and combined diagnosis of SPECT bone imaging, CYFRA21-1 and CEA were analyzed. Results The incidence of bone metastasis of NSCLC was 58.59%, and the incidence of bone metastasis of adenocarcinoma(64.62%) was significantly higher than that of squamous cell carcinoma(48.78%)(P<0.05). Bone metastasis was the most common in ribs(59.68%), followed by spine(51.61%). Spearman correlation analysis showed that levels of CYFRA21-1 and CEA were positively correlated with bone metastasis(r=0.317, r=0.574, P<0.05). The receiver operating characteristic curve(ROC) analysis found that the area under the curve(AUC) of SPECT bone imaging combined with CYFRA21-1 and CEA was 0.917, higher than single diagnosis. Conclusion Compared with the diagnosis of single indicator, SPECT bone imaging combined with serum CYFRA21-1 and CEA can help the detection of bone metastasis in patients with NSCLC.

关 键 词：SPECT骨显像 CYFRA21-1 CEA NSCLC 骨转移 

分 类 号：R44[医药卫生—诊断学] R734.2[医药卫生—临床医学]