64排螺旋CT联合血清肿瘤标志物在周围型肺癌术前分期诊断中的应用  

Application of 64-slices spiral CT combined with serum tumor markers in preoperative staging diagnosis of peripheral lung cancer

作　　者：郭琼 蒋佶廷 邓绍强[1] GUO Qiong;JIANG Ji-ting;DENG Shao-qiang(Department of Radiology,Guang'an People's Hospital,Guangan,Sichuan 638000,China;不详)

机构地区：[1]广安市人民医院放射科,四川广安638000

出　　处：《中国医学装备》2021年第7期71-75,共5页China Medical Equipment

基　　金：2018年四川省卫生和计划生育委员会科研课题(18PJ129)“基于影像组学低剂量CT筛检肺结节及预测良恶性研究”。

摘　　要：目的:分析64排螺旋CT联合血清肿瘤标志物在周围型肺癌术前分期诊断中的应用价值。方法:选取医院接受手术治疗的130例肺癌患者的临床资料,根据病灶位置分为中央型肺癌组(80例)和周围型肺癌组(50例),两组患者术前均接受64排螺旋CT检查,采集血液样本后测定血清肿瘤标志物[癌胚抗原(CEA),细胞角蛋白19片段21-1(CYFRA21-1),神经元特异性烯醇化酶(NSE)]并进行对比,分析64排螺旋CT联合血清肿瘤标志物在周围型肺癌术前肿瘤、淋巴结及转移(TNM)分期诊断中的应用效果。结果:中央型肺癌组患者血清CEA、CYFRA21-1及NSE均高于周围型肺癌组患者,差异有统计学意义(t=2.459,t=1.897,t=2.023;P<0.05);周围型肺癌组内不同TNM分期患者血清肿瘤标志物相比较,Ⅱ期<ⅢA期<ⅢB期+Ⅳ期,差异有统计学意义(F=5982.512,F=236.733,F=51.850;P<0.05);病理结果证实,周围型肺癌组50例患者中Ⅱ期17例,ⅢA期27例,ⅢB期+Ⅳ期6例。64排螺旋CT联合血清肿瘤标志物检测,其诊断符合率、术前分期诊断灵敏度及特异度均优于64排螺旋CT和血清肿瘤标志物单独使用,差异有统计学意义(x^(2)=4.099,x^(2)=10.727,x^(2)=16.458;P<0.05);64排螺旋CT和血清肿瘤标志物之间差异无统计学意义。结论:在周围型肺癌术前分期诊断中,64排螺旋CT联合血清肿瘤标志物能够取得理想的应用效果。Objective:To analyze the application value of 64-slices spiral computed tomography(CT)combined with serum tumor markers in preoperative staging diagnosis of peripheral lung cancer.Methods:The clinical data of 130 patients with lung cancer who underwent surgery in hospital were retrospectively analyzed.And they were divided into the central type of lung cancer group(80 cases)and the peripheral lung cancer group(50 cases)according to the location of the lesion.64-slices spiral CT examinations were performed on both two groups.And blood samples were collected and serum tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1)and neuron-specific enolase(NSE)]of them were measured,and then they were further compared.The applied effects of 64-slices spiral CT combined with serum tumor markers in the preoperative diagnosis of tumor-node-metastasis(TNM)staging of peripheral lung cancer were analyzed.Results:The CEA,CYFRA21-1 and NSE of serum tumor markers of central type of lung cancer group were significantly higher than those of peripheral lung cancer group(t=2.459,t=1.897,t=2.023,P<0.05).In the comparison of the serum tumor markers of patients with different TNM staging within peripheral lung cancer group,the results were“II stage<III A stage<III B stage+IV stage”,and the differences of them among different stages were significant(F=5982.512,F=236.733,F=51.850,P<0.05).The pathological results indicated that 17 cases were in II stage,and 27 cases were in III A stage,and 6 cases were in III B stage+IV stage in 50 patients of peripheral lung cancer group.And the diagnostic accordance rate,and the sensitivity and specificity of preoperative staging diagnosis of the combined detection of 64-slices spiral CT and serum tumor markers were significantly better than 64-slices spiral CT and serum tumor marker(x^(2)=4.099,x^(2)=10.727,x^(2)=16.458,P<0.05),respectively.And the differences of diagnostic effects between 64-slices spiral CT and serum tumor markers were no significant.Conclusion:64-slices

关 键 词：周围型肺癌 64排螺旋CT 血清肿瘤标志物 术前分期诊断 

分 类 号：R816.41[医药卫生—放射医学]