薄层CT扫描联合血清肿瘤标志物在孤立性肺结节良恶性诊断中的应用价值研究  

Application Value of Thin-slice CT Combined with Serum Tumor Markers in the Diagnosis of Benign and Malignant Solitary Pulmonary Nodules

作　　者：牟干 官莉[1] 马潇枭 刘玲[1] 高宝安[1] MOU Gan;GUAN Li;MA Xiaoxiao;LIU Ling;GAO Baoan(Department of Pulmonary and Critical Care Medicine,the First College of Clinical Medical Science,China Three Gorges University/Yichang Central People's Hospital,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院,宜昌市中心人民医院呼吸与危重症医学科,湖北省宜昌市443003

出　　处：《实用心脑肺血管病杂志》2021年第5期104-108,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景肺癌发病率及死亡率较高,若能早期诊断、早期干预,将明显延长患者生存时间;且肺癌的早期诊断正是呼吸肿瘤界的难点与热点。目的分析薄层CT扫描联合血清肿瘤标志物在孤立性肺结节(SPN)良恶性诊断中的应用价值。方法回顾性选取2018年8月—2020年8月就诊于宜昌市中心人民医院的SPN患者154例为研究对象,其中恶性SPN 92例、良性SPN 62例。收集患者一般资料、薄层CT扫描结果、血清肿瘤标志物检测结果,以病理结果为诊断金标准,绘制受试者工作特征(ROC)曲线以评估薄层CT扫描、血清肿瘤标志物及其联合诊断恶性SPN的价值。结果恶性SPN患者年龄大于良性SPN患者,有吸烟史者所占比例高于良性SPN患者(P<0.05)。薄层CT扫描诊断恶性SPN的曲线下面积(AUC)为0.727〔95%CI(0.647,0.807)〕,灵敏度为76.1%,特异度为80.6%;血清肿瘤标志物诊断恶性SPN的AUC为0.634〔95%CI(0.544,0.725)〕,灵敏度为56.5%,特异度为72.6%;薄层CT扫描联合血清肿瘤标志物诊断恶性SPN的AUC为0.850〔95%CI(0.788,0.912)〕,灵敏度为85.9%,特异度为69.4%。结论薄层CT扫描联合血清肿瘤标志物诊断恶性SPN的灵敏度较高,有利于恶性SPN的早期发现,其在SPN良恶性诊断中有一定应用价值,值得临床推广,但其也存在一定的假阳性情况,应注意鉴别,必要时进行穿刺活检以明确诊断。Background The incidence and mortality of lung cancer are high.Early diagnosis and early intervention will significantly prolong the survival time of patients;and early diagnosis of lung cancer is the difficulty and hot spot in the field of respiratory tumors.Objective To analyze the application value of thin-slice CT combined with serum tumor markers in the diagnosis of benign and malignant solitary pulmonary nodules(SPN).Methods A total of 154 patients with SPN treated in Yichang Central People's Hospital from August 2018 to August 2020 were retrospectively selected,including 92 cases of malignant SPN and 62 cases of benign SPN.The general data,results of thin-slice CT and the detection results of serum tumor markers of the patients were collected.The pathological results were taken as the gold standard for diagnosis.The receiver operating characteristic(ROC)curve was drawn to evaluate the value of thin-slice CT,serum tumor markers and their combination in the diagnosis of malignant SPN.Results The age of patients with malignant SPN was older than that the patients with benign SPN,and the proportion of patients with smoking history was higher than that of patients with benign SPN(P<0.05).The AUC for the diagnosis of malignant SPN by thin-slice CT was 0.727〔95%CI(0.647,0.807)〕,the sensitivity and specificity was 76.1%and 80.6%,respectively.The AUC of serum tumor markers in the diagnosis of malignant SPN was 0.634〔95%CI(0.544,0.725)〕,the sensitivity and specificity was 56.5%and 72.6%,respectively.The AUC of thin-slice CT combined with serum tumor markers in the diagnosis of malignant SPN was 0.850〔95%CI(0.788,0.912)〕,the sensitivity and specificity was 85.9%and 69.4%,respectively.Conclusion Thin-slice CT combined with serum tumor markers has a high sensitivity in the diagnosis of malignant SPN,which is beneficial to the early detection of malignant SPN.It has a certain application value in the diagnosis of benign and malignant SPN and is worthy of clinical promotion.However,there are also some false p

关 键 词：孤立性肺结节 薄层CT扫描 生物标记 肿瘤 诊断 鉴别 

分 类 号：R521.6[医药卫生—内科学]