血清TK1 CYFRA21-1和SCC-Ag联合胸部CT影像特征诊断良恶性肺结节  

Clinical value of serum TK1,CYFRA21-1 and SCC-Ag combined with chest CT imaging features in the diagnosis of benign and malignant pulmonary nodules

作　　者：王媛媛 叶维霞[2] 熊佳 蓝杨[1] 雷蕾 陈艳鸿[2] WANG Yuanyuan;YE Weixia;XIONG Jia;LAN Yang;LEI Lei;CHEN Yanhong(Department of Respiratory Medicine,Luzhou People’s Hospital,Luzhou 646000,Sichuan,China;Department of Gastroenterology,Luzhou People’s Hospital,Luzhou 646000,Sichuan,China;Department of Pediatrics,Luzhou People’s Hospital,Luzhou 646000,Sichuan,China)

机构地区：[1]泸州市人民医院呼吸内科,四川泸州646000 [2]泸州市人民医院消化内科,四川泸州646000 [3]泸州市人民医院儿科,四川泸州646000

出　　处：《西部医学》2021年第9期1340-1343,共4页Medical Journal of West China

基　　金：泸州市科技局基金项目[2013-S-46(6/6)]。

摘　　要：目的探讨血清胸苷激酶1(TK1)、细胞角蛋白19片段21-1(CYFRA21-1)、鳞状细胞癌抗原(SCC-Ag)联合胸部CT影像特征在良恶性肺结节诊断中的临床价值。方法选取2017年2月~2020年1月于我院就诊的105例肺结节患者作为研究对象,根据经手术、纤支镜、肺结节穿刺活检等检查结果分为良性组(n=45)和恶性组(n=60),对比两组血清TK1、CYFRA21-1、SCC-Ag水平和胸部CT影像特征,并分析比较血清TK1、CYFRA21-1、SCC-Ag联合胸部CT影像特征对良恶性肺结节的诊断效能。结果恶性组血清TK1、CYFRA21-1、SCC-Ag水平均高于良性组(P<0.05);恶性组分叶征、毛刺征、胸膜凹陷征、血管集束征比例高于良性组(P<0.05);ROC曲线分析显示,血清TK1、CYFRA21-1、SCC-Ag联合胸部CT分叶征、毛刺征、胸膜凹陷征、血管集束征征象鉴别诊断良恶性肺结节的AUC值最大,为0.901,诊断敏感度及特异度最高,分别为86.67%、88.89%。结论恶性肺结节患者血清TK1、CYFRA21-1、SCC-Ag水平较高,且胸部CT影像特征多表现为分叶征、毛刺征、胸膜凹陷征、血管集束征,血清TK1、CYFRA21-1、SCC-Ag联合胸部CT影像特征对良恶性肺结节的鉴别诊断有一定价值。Objective To investigate the clinical value of serum thymidine kinase 1(TK1),cytokeratin 19 fragment 21-1(CYFRA21-1)and squamous cell carcinoma antigen(SCC-Ag)combined with chest CT imaging features in the diagnosis of benign and malignant pulmonary nodules.Methods 105 patients with pulmonary nodules who were treated in the hospital from February 2017 to January 2020 were selected as the research subjects.All of them were subjected to chest CT examination and detection of serum TK1,CYFRA21-1 and SCC-Ag levels.According to pathological findings,the patients were divided into benign group and malignant group.Serum TK1,CYFRA21-1 and SCC-Ag levels and chest CT imaging features of the two groups were compared.The diagnostic efficiency of serum TK1,CYFRA21-1 and SCC-Ag combined with chest CT for benign and malignant pulmonary nodules was analyzed.Results Serum TK1,CYFRA21-1 and SCC-Ag levels in the malignant group were higher than those in the benign group(P<0.05).The proportions of lobulation sign,spicule sign,pleural indentation and vessel convergence sign in the malignant group were higher than those in the benign group(P<0.05).ROC curve analysis showed that the AUC value of serum TK1,CYFRA21-1 and SCC-Ag combined with chest CT lobulation sign,spicule sign,pleural indentation and vessel convergence sign in differential diagnosis of benign and malignant pulmonary nodules was the largest(0.901).Meanwhile,the diagnostic sensitivity and specificity were the highest(86.67%and 88.89%).Conclusion Patients with malignant pulmonary nodules have higher serum TK1,CYFRA21-1 and SCC-Ag levels.Besides,chest CT imaging features mainly include lobulation sign,spicule sign,pleural indentation and vessel convergence sign.Serum TK1,CYFRA21-1 and SCC-Ag combined with chest CT imaging features have certain value in the differential diagnosis of benign and malignant pulmonary nodules.

关 键 词：肺结节 胸苷激酶1 细胞角蛋白19片段21-1 鳞状细胞癌相关抗原 CT 

分 类 号：R734.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]