低剂量CT薄层重建联用P16基因甲基化检测对肺小结节良恶性的诊断  

Low-dose CT Thin-slice Reconstruction Combined with P16 Gene Methylation Detection in the Diagnosis of Benign and Malignant Pulmonary Nodules

作　　者：田庆龙 章政 王全[2] 宋长悦[2] TIAN Qinglong;ZHANG Zheng;WANG Quan;SONG Changyue(Department of Imaging,Heilongjiang Tianyuan Obstetrics and Gynecology Hospital,Harbin,Heilongjiang Province,150000 China;Department of Imaging,Heilongjiang Provincial Hospital,Heilongjiang Province,Harbin,Heilongjiang Province,150000 China)

机构地区：[1]黑龙江天元妇产医院影像科,黑龙江哈尔滨150000 [2]黑龙江省医院影像科,黑龙江哈尔滨150000

出　　处：《中外医疗》2021年第24期1-4,共4页China & Foreign Medical Treatment

基　　金：2020年哈尔滨市医疗卫生新技术应用项目(20202029-2)。

摘　　要：目的探究低剂量CT(LDCT)薄层重建联合外周血清P16基因甲基化检测对肺小结节良恶性早期诊断的应用价值。方法方便选取2018年2月—2019年10月间,既往已查明肺小结节(≤1 cm)的患者1115例,将其随机分为两组,一组557例(LDCT薄层重建-P16组),行低剂量螺旋CT扫描薄层重建联用外周血清P16基因甲基化检测;二组558例(LDCT组),仅采用普通低剂量螺旋CT扫描。观察两组病例影像学特征:毛刺、分叶、胸膜牵拉、小泡征和钙化,LDCT薄层重建-P16组另需观察P16基因甲基化检测特异带。结果LDCT薄层重建-P16组中有182例的患者怀疑恶性可能大,阳性检出率明显高于LDCT组。最终病理证实LDCT薄层重建-P16组对肺小结节良恶性诊断准确率(92.31%),明显高于LDCT组(51.92%),两组差异有统计学意义(P<0.05)。结论低剂量螺旋CT薄层重建联用P16基因甲基化检测有助于判断肺小结节良恶性的,为临床早期发现肺癌提供一种新的手段。Objective To explore the application value of low-dose CT(LDCT)thin-slice reconstruction combined with peripheral serum P16 gene methylation detection in the early diagnosis of benign and malignant pulmonary nodules.Methods From February 2018 to October 2019,1115 patients with pulmonary nodules(≤1 cm)were previously identified and conveniently selected,and they were randomly divided into two groups,one group of 557 patients(LDCT thin-slice reconstruction-P16 group),low-dose spiral CT scan thin-slice reconstruction combined with peripheral serum P16 gene methylation detection;two groups of 558 cases(LDCT group),only ordinary low-dose spiral CT scan.The imaging characteristics of the two groups of cases were observed:burrs,lobes,pleural traction,vesicle sign,and calcification.In the LDCT thin-layer reconstruction-P16 group,it is necessary to observe the specific bands of P16 gene methylation detection.Results In the LDCT thin-slice reconstruction-P16 group,182 patients were suspected of being malignant,and the positive detection rate was significantly higher than that of the LDCT group.The final pathology confirmed that the LDCT thin-layer reconstruction-P16 group had a diagnostic accuracy rate of benign and malignant pulmonary nodules(92.31%),which was significantly higher than that of the LDCT group(51.92%).The difference between the two groups was statistically significant(P<0.05).Conclusion Low-dose spiral CT thin-slice reconstruction combined with P16 gene methylation detection is helpful to judge the benign and malignant pulmonary nodules,and provides a new method for early detection of lung cancer in clinical practice.

关 键 词：体层摄影术 X线计算机 薄层重建 P16基因甲基化 肺小结节 

分 类 号：R4[医药卫生—临床医学]