CT影像学联合细胞角蛋白19片段抗原对周围性肺癌患者的临床诊断价值  

Clinical Diagnostic Value of CT Imaging Combined with Cytokeratin 19 Fragment Antigen in Peripheral Lung Cancer

作　　者：任茂 张会峰 王天轶 REN Mao;ZHANG Hui-feng;WANG Tian-yi(Department of Respiratory Medicine,980th(Bethune International Peace)Hospital of the Chinese People's Liberation Army,Shijiazhuang 050004,Hebei Province,China;Department of Laboratory Medicine,980th(Bethune International Peace)Hospital of the Chinese People's Liberation Army,Shijiazhuang 050004,Hebei Province,China)

机构地区：[1]中国人民解放军联保部队第980(白求恩国际和平)医院呼吸内科,河北石家庄050004 [2]中国人民解放军联保部队第980(白求恩国际和平)医院检验科,河北石家庄050004

出　　处：《中国CT和MRI杂志》2021年第6期68-70,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨CT影像学联合细胞角蛋白19片段抗原对周围性肺癌患者的临床诊断价值。方法经诊断、纳入与排除后共有80例(2010年1月至2018年1月)周围性肺癌患者参与本研究。所有患者接受CT、CY-FRA21-1及病理检查。结果不同病灶大小、侵袭、肿瘤边缘形态、积液、淋巴结转移CT影像学特征的CYFRA21-1水平差异比较有统计血意义(P<0.05)。病灶>3cm的CYFRA21-1水平大于≤3cm、侵袭CYFRA21-1水平大于未侵袭、粗糙肿瘤边缘形态CYFRA21-1水平大于光滑、分叶CYFRA21-1水平大于未分叶、有积液CYFRA21-1水平大于无积液、有淋巴结转移CYFRA21-1水平大于无淋巴结转移。血管断面、钙化及胸膜凹陷征CYFRA21-1水平差异比较无统计学意义(P>0.05)。CT诊断周围性肺癌正确率为66.25%,CYFRA21-1诊断正确性为52.50%,联合诊断正确率为92.50%。联合诊断正确率显著高于单CT、 CY F R A 2 1-1(P<0.05)。周围性肺癌以腺癌常见(73.75%),鳞癌26.25%。血管断面中腺癌(79.53%),鳞癌24.07%。>3cm病灶中腺癌72.09%,鳞癌27.91%。侵袭影像中腺癌78.85%,鳞癌21.15%。肿瘤形态粗糙征中腺癌59.38%,鳞癌40.63%。分叶征中腺癌72.22%,鳞癌21.78%。胸膜凹陷中腺癌86.67%,鳞癌13.33%。积液征中腺癌89.74%,鳞癌10.53%。钙化征中腺癌78.95%,鳞癌20.05%。淋巴结转移征腺癌98.33%,鳞癌1.67%。结论 CT影像学联合细胞角蛋白19片段抗原能提高周围性肺癌诊断正确性,减少误诊及错诊,能指导临床。Objective To investigate the clinical diagnostic value of CT imaging combined with cytokeratin 19 fragment antigen(CYFRA21-1)in peripheral lung cancer.Methods A total of 80 patients with peripheral lu ng cancer(January 2010-January 2018)were en rolled in this study after diagnosis,inclusion,and exclusion.All patients received CT,CY-FRA21-1,and pathological exa mination.Results CYFRA21-1 levels showed significant differences among patients with different lesion sizes,invasion,tumor margin morphology,effusion,and lymph node metastasis(P<0.05).CYFRA21-1 levels were higher in patients with lesions>3 cm,invasion,ma rginal morphology of the tumor,lobulation,effusion,and lymph node metastasis than those with lesions≤3 cm,no invasion,smooth tumor margin,lobulation,no effusion,and no lymph node metastasis(P<0.05).The levels of CYFRA21-1 showed no difference in vascular section,calcification,and pleural indentation(P>0.05).The diagnostic accuracy of combined detection of the methods for peripheral lu ng cancer was higher than the single examination of CT or CYFRA21-1(92.50%vs.66.25%,52.50%,P<0.05).Adenocarcinoma accounted for 73.75%,79.53%,72.09%,78.85%,59.38%,72.22%,86.67%,89.74%,78.95%,and 98.33%,while the squamous cell carcinoma accounted for 26.25%,24.07%,27.91%,21.15%,40.63%,21.78%,13.33%,10.53%,20.05%,and1.67%in peripheral lung cancer,vascular section,lesions>3 cm,invasion,rough tumor morphology,lobulation sign,pleural depression,hydrocele sign,calcification sign,lymph node metastasis sign.Conclusion CT imaging combined with CY-FRA21-1 can improve the diagnostic accuracy of peripheral lung cancer,reduce misdiagnosis,and guide clinical practice.

关 键 词：CT 细胞角蛋白19片段抗原 周围性肺癌 影像学 

分 类 号：R445.3[医药卫生—影像医学与核医学] R734.2[医药卫生—诊断学]