多层螺旋CT联合肿瘤标志物检测在尘肺合并肺癌诊断中的临床价值  

The Clinical Value of Multi-slice Spiral CT Combined with Detection of Tumor Markers in the Diagnosis of Pneumoconiosis Complicated with Lung Cancer

作　　者：冯选鹏[1] 张文须[1] 肖占森[2] FENG Xuanpeng;ZHANG Wenxu;XIAO Zhansen(Department of Respiratory Medicine,Fangshan First Hospital,Beijing,102400 China;Department of Imaging(Nuclear Medicine),Fangshan First Hospital,Beijing,102400 China)

机构地区：[1]北京市房山区第一医院呼吸内科,北京102400 [2]北京市房山区第一医院影像科(核医学),北京102400

出　　处：《中外医疗》2021年第14期172-176,共5页China & Foreign Medical Treatment

摘　　要：目的在尘肺合并肺癌患者的诊断过程中应用多层螺旋CT与肿瘤标志物CEA、CA125、NSE、CYFRA21-1联合检测方法的临床效果进行分析。方法方便选取2014年1月—2019年1月该院收治的68例确诊尘肺合并肺癌患者,对患者进行多层螺旋CT联合肿瘤标志物检测,并在1周内检测血清中肿瘤标志物,分析两种检查之间的差异和相互关系。结果①中央型尘肺合并肺癌36例,周围型尘肺合并肺癌32例。其中腺癌32例,鳞癌26例,小细胞癌10例。②尘肺合并肺癌组患者的CEA指标为(23.49±16.37)ng/mL,CA125指标为(28.40±13.33)U/mL,NSE指标为(25.63±16.28)ng/mL,CYFRA21-1指标为(17.23±7.91)ng/mL,良性肺病组患者的各项指标分别为(2.43±1.32)ng/mL、(22.35±6.78)U/mL、(11.96±4.09)ng/mL、(2.26±1.36)ng/mL,尘肺合并肺癌组明显较高,差异有统计学意义(t=11.031、3.450、6.989、16.029,P<0.05);③关于血清CEA,CA125指标,腺癌组患者分别为(81.25±15.86)ng/mL、(165.34±18.32)U/mL,鳞癌组为(5.19±2.35)ng/mL、(113.63±13.25)U/mL,小细胞癌组为(6.56±1.49)ng/mL、(107.03±12.74)U/mL,腺癌明显高于鳞癌和小细胞癌,差异有统计学意义(P<0.05);关于CYFRA21-1指标,腺癌(21.58±4.85)ng/mL、鳞癌(23.82±4.11)ng/mL显著高于小细胞癌(5.91±1.35)ng/mL,差异有统计学意义(P<0.05);关于NSE指标,腺癌(20.31±4.34)ng/mL、鳞癌(18.69±4.05)ng/mL与小细胞癌(58.61±13.46)ng/mL相比明显较低,差异有统计学意义(P<0.05);④血清肿瘤标志物CEA诊断尘肺合并肺癌的灵敏度、特异性、准确性为别为55.9%、52.7%、54.2%;CA125诊断尘肺合并肺癌的灵敏度、特异性、准确性为别为54.4%、64.9%、59.9%;NSE诊断尘肺合并肺癌的灵敏度、特异性、准确性为别为77.9%、67.6%、72.5%;CYFRA21-1诊断尘肺合并肺癌的灵敏度、特异性、准确性为别为77.9%、66.2%、71.8%;CEA、CA125、NSE、CYFRA21-1四种肿瘤标志物联合检测的灵敏度、特异性、准确性分别为80.9%、79.7%、80.3%Objective To analyze the clinical effects of multi-slice spiral CT and tumor markers CEA,CA125,NSE,CYFRA21-1 in the diagnosis of patients with pneumoconiosis and lung cancer.Methods A total of 68 patients with confirmed pneumoconiosis and lung cancer admitted to the hospital from January 2014 to January 2019 were convenient selected.The patients were subjected to multi-slice spiral CT combined with tumor marker detection,and the serum tumor markers were detected within one week,and the differences and interrelationships of the two types were analyzed.Results 1.36 cases of central pneumoconiosis with lung cancer and 32 cases of peripheral pneumoconiosis with lung cancer.There were 32 cases of adenocarcinoma,26 cases of squamous cell carcinoma,and 10 cases of small cell carcinoma.2.In the pneumoconiosis and lung cancer group,the CEA index was(23.49±16.37)ng/mL,the CA125 index was(28.40±13.33)U/mL,the NSE index was(25.63±16.28)ng/mL,and the CYFRA21-1 index was(17.23±7.91)ng/mL,the indicators of patients in the benign lung disease group were(2.43±1.32)ng/mL,(22.35±6.78)U/mL,(11.96±4.09)ng/mL,(2.26±1.36)ng/mL,the pneumoconiosis with lung cancer group was significantly higher,and the difference was statistically significant(t=11.031,3.450,6.989,16.029,P<0.05);3.Regarding serum CEA and CA125 indicators,the adenocarcinoma group was respectively(81.25±15.86)ng/mL,(165.34±18.32)U/mL,(5.19±2.35)ng/mL,(113.63±13.25)U/mL in the squamous cell carcinoma group,and(6.56±1.49)ng/mL,(107.03±12.74)U/mL,adenocarcinoma was significantly higher than squamous cell carcinoma and small cell carcinoma,the difference was statistically significant(P<0.05);about CYFRA21-1 index,adenocarcinoma(21.58±4.85)ng/mL,squamous cell carcinoma(23.82±4.11)ng/mL were significantly higher than small cell carcinoma(5.91±1.35)ng/mL,the difference was statistically significant(P<0.05);regarding the NSE index,adenocarcinoma(20.31±4.34)ng/mL and squamous cell carcinoma(18.3±4.05)ng/mL were significantly lower than small cell carcinoma(58.61±

关 键 词：多层螺旋CT 肿瘤标志物检测 尘肺 肺癌 临床价值 

分 类 号：R4[医药卫生—临床医学]