低剂量螺旋CT联合肿瘤标志物CEA,SCC-Ag,ProGRP,NSE对良恶性孤立性肺结节的鉴别诊断价值  

Differential Diagnosis Value of Low Dose Spiral CT Combined with Tumor Markers CEA,SCC-Ag、ProGRP、NSE for Benign and Malignant Solitary Pulmonary Nodules

作　　者：裴东方 陈少武[2] 李静 PEI Dongfang;CHEN Shaowu;LI Jing(The Second People's Hospital of Pingdingshan,Pingdingshan,467000)

机构地区：[1]河南省平顶山市第二人民医院,467000 [2]河南省平顶山市第一人民医院,467000

出　　处：《实用癌症杂志》2021年第4期614-617,共4页The Practical Journal of Cancer

摘　　要：目的探讨低剂量螺旋CT联合肿瘤标志物癌胚抗原(CEA),鳞状上皮细胞癌相关抗原(SCC-Ag),胃泌素释放肽前体(ProGRP),神经特异性烯醇化酶(NSE)对良恶性孤立性肺结节的鉴别诊断价值。方法回顾性分析孤立性肺结节患者420例的临床资料,患者均有完整的低剂量螺旋CT及肿瘤标志物CEA、SCC-Ag、ProGRP、NSE检查结果和病理结果,以病理结果为金标准确定结节性质,比较良、恶性孤立性肺结节患者的低剂量螺旋CT的结节显示情况及肿瘤标志物CEA、SCC-Ag、ProGRP、NSE水平,比较低剂量螺旋CT和肿瘤标志物CEA、SCC-Ag、ProGRP、NSE单独检查及联合检查对良、恶性孤立性肺结节的检出率。结果病理结果提示420例孤立性肺结节患者中,良性287例,恶性133例。低剂量螺旋CT检查显示:良、恶性患者的结节直径、类型、结节形态、结节与肺的交界面、结节的边缘特征比较,差异均有统计学意义(P<0.05)。肿瘤标志物检查显示良性患者的血清CEA、SCC-Ag、ProGRP、NSE水平均显著低于恶性患者(P<0.05)。低剂量螺旋CT和肿瘤标志物联合检查对良、恶性孤立性肺结节的检出率均显著高于单独检查(P<0.05)。结论低剂量螺旋CT联合肿瘤标志物CEA、SCC-Ag、ProGRP、NSE对良恶性孤立性肺结节检出率高,并且对良、恶性结节具有鉴别诊断价值,可以为临床诊治工作提供指导信息。Objective To investigate the differential diagnosis value of low dose spiral CT combined with tumor markers CEA,SCC-Ag,ProGRP,NSE for benign and malignant solitary pulmonary nodules.Methods Clinical data of 420 patients with solitary pulmonary nodules diagnosed and treated were analyzed retrospectively,the patients had complete low dose spiral CT and tumor markers CEA,SCC-Ag,ProGRP,NSE examination results and pathological results,used pathological results as the gold standard to determine the nature of nodules,compared the nodule display of low dose spiral CT and the levels of tumor markers CEA,SCC-Ag,ProGRP and NSE in patients with benign and malignant solitary lung nodules,compared the detection rates of low dose spiral CT and tumor markers CEA,SCC-Ag,ProGRP,NSE alone and combined examination for benign and malignant solitary pulmonary nodules.Results Pathological results suggested that among the 420 patients with solitary pulmonary nodules in this group,287 were benign and 133 were malignant.Low dose spiral CT examination showed that the diameter,type,morphology of nodule,the interface between nodule and lung,and the edge characteristics of nodule in benign and malignant patients has statistical differences(P<0.05).Tumor marker examination showed that serum CEA,SCC-Ag,ProGRP and NSE levels of benign patients were significantly lower than those of malignant patients(P<0.05).The detection rate of low dose spiral CT and tumor markers combined examination for benign and malignant solitary pulmonary nodules was significantly higher than that of single examination(P<0.05).Conclusion Low dose spiral CT combined with tumor markers CEA,SCC-Ag,ProGRP,NSE has a high detection rate for benign and malignant solitary pulmonary nodules,and has differential diagnosis value for benign and malignant nodules,and can provide guidance for clinical diagnosis and treatment.

关 键 词：孤立性肺结节 良性 恶性 低剂量螺旋CT 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]