PET联合血清肿瘤标志物对肺鳞癌与小细胞癌的鉴别价值  

PET Combined with Serum Tumor Markers in Differentiating Lung Squamous Cell Carcinoma and Small Cell Carcinoma

作　　者：翁绳和 徐雪 孙祎繁 唐荔莺 蒋日烽[2] WENG Shenghe;XU Xue;SUN Yifan(Department of Medical Technology,Fujian Health College,Fuzhou,Fujian Province 350101,P.R.China)

机构地区：[1]福建卫生职业技术学院医学技术系,福州350101 [2]福建医科大学附属协和医院放射科,福州350001

出　　处：《临床放射学杂志》2020年第1期52-56,共5页Journal of Clinical Radiology

摘　　要：目的研究PET/CT与血清肿瘤标志物联合对肺鳞癌和小细胞癌的鉴别价值。方法回顾性分析34例肺鳞癌患者和48例小细胞癌患者的临床、血清肿瘤标志物及18F-FDG PET/CT的资料。测量肺癌原发病灶的最大标准摄取值(SUVmax)并记录CEA、Cyfra21-1及NSE的血清水平。采用独立样本t检验比较鳞癌和小细胞癌间SUVmax和血清肿瘤标志物水平的差异。二元Logistic回归分析用于联合SUVmax和血清肿瘤标志物。ROC曲线进一步评估SUVmax,每种血清肿瘤标志物,CEA+Cyfra21-1+NSE和SUVmax+血清肿瘤标志物的鉴别诊断效能。结果鳞癌的SUVmax显著高于小细胞癌(P=0.028);小细胞癌患者中NSE显著高于鳞癌患者(P=0.001),鳞癌患者中Cyfra21-1显著高于小细胞癌患者(P=0.012),而CEA在鳞癌和小细胞癌患者间无显著性差异(P=0.746)。单独使用SUVmax、CEA、Cyfra21-1和NSE鉴别鳞癌和小细胞癌的ROC曲线下面积(AUC)分别为0.672、0.554、0.712和0.777。当三种肿瘤标志物联合时,CEA+Cyfra21-1+NSE的AUC增加至0.929,而当SUVmax进一步加入时,SUVmax+血清肿瘤标志物的AUC进一步提升,增加至0.937。结论PET/CT紧密结合肺癌相关血清肿瘤标志物可以实现对肺鳞癌和小细胞癌更好地鉴别。Objective Identification of small cell lung carcinoma(SCLC)and squamous cell carcinoma(SCC)is important for the subsequent treatment and prognosis.The aim of this study was to investigate the value of SUVmax combined with serum tumor markers for differentiating SCLC and SCC.Methods The clinical,serum tumor markers and 18F-FDG PET/CT data of 34 patients with lung SCC and 48 patients with SCLC were retrospectively collected.The maximal standard uptake values(SUVmax)of primary lesions of lung cancer were measured and serum levels of CEA,Cyfra 21-1 and NSE were recorded.The independent sample t test was used to compare the difference in SUVmax and serum tumor marker levels between SCLC and SCC.Binary Logistic regression analysis was used to combine SUVmax and serum tumor markers.The ROC curves further evaluated the diagnostic efficiency of SUVmax,each serum tumor marker,CEA+Cyfra21-1+NSE and SUVmax+serum tumor markers in differentiation.Results SUVmax of SCC was significantly higher than that of SCLC(P=0.028);NSE was significantly higher in patients with SCLC than in patients with SCC(P=0.001);and Cyfra21-1 was significantly higher in patients with SCC than in SCLC(P=0.012).In constrast,there was no significant difference in CEA between patients with SCC and SCLC(P=0.746).The area under the ROC curves(AUC)of SUVmax,CEA,Cyfra21-1,and NSE alone for differentiating SCC and SCLC was 0.672,0.554,0.712,and 0.777,respectively.When the three tumor markers were combined,the AUC of CEA+Cyfra21-1+NSE increased to 0.929,and when SUVmax was further combined,the AUC of SUVmax+serum tumor markers further increased to 0.937.Conclusion SUVmax and serum tumor markers have certain value in the identification of SCC and SCLC.After proper combination,the diagnostic efficiency can be significantly improved.Therefore,the diagnosis of images should be closely combined with serum tumor markers for better diagnosis of both lung cancers.

关 键 词：正电子发射型计算机断层显像 肿瘤标志物 鳞癌 小细胞癌 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]