CT征象联合肿瘤标志物对孤立性肺结节良恶性的鉴别诊断分析  

Value of CT signs combined with tumor markers in differential diagnosis of benign and malignant solitary pulmonary nodules

作　　者：晁培培 丁锋 肖辉 杜丹丹[2] CHAO Peipei;DING Feng;XIAO Hui;DU Dandan(CT room of Suixi County Hospital, Huaibei 235100, P.R.China;Department of Medical Imaging, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, P.R.China)

机构地区：[1]安徽省濉溪县医院CT室,安徽淮北235100 [2]安徽医科大学第一附属医院医学影像科,安徽合肥230022

出　　处：《医学影像学杂志》2022年第2期236-239,253,共5页Journal of Medical Imaging

摘　　要：目的探讨CT征象联合肿瘤标志物对孤立性肺结节良恶性的鉴别诊断价值。方法选取70例孤立性肺结节患者,行高分辨率CT、肿瘤标志物检查及病理检查。以病理组织学检查结果分为恶性结节组39例,良性结节组31例,对比两组CT征象和肿瘤标志物水平差异,运用受试者工作特征曲线(ROC)分析CT联合肿瘤标志物检测鉴别孤立性肺结节良恶性的临床价值。结果良性组与恶性组年龄、结节直径、性别等基础临床资料比较,未见统计学差异(P>0.05)。恶性组典型结节并深分叶、胸膜凹陷、短细毛刺、多囊性亮影、支气管血管集束征、棘状突起检出率高于良性组,良性组相邻胸膜增厚、卫星灶检出率高于恶性组,差异有统计学意义(P<0.05)。恶性组血清鳞状上皮细胞癌抗原(SCC)、神经特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA-21)、癌胚抗原(CEA)均高于良性组,差异有统计学意义(P<0.05)。CT鉴别诊断孤立性肺结节良恶性的灵敏度、特异性、准确率分别为74.36%、87.10%、80.00%;肿瘤标志物鉴别诊断孤立性肺结节良恶性的灵敏度、特异性、准确率分别为87.18%、51.61%、71.43%。ROC曲线显示,CT联合肿瘤标志物鉴别诊断孤立性肺结节良恶性的曲线下面积(AUC)为0.841,灵敏度、特异性、准确率分别为92.31%、93.55%、92.86%。结论CT征象联合肿瘤标志物能够为孤立性肺结节良恶性的鉴别诊断提供可靠参考依据。Objective To analyze the value of CT signs combined with tumor markers in differential diagnosis of benign and malignant solitary pulmonary nodules.Methods 70 patients with solitary pulmonary nodules in our hospital from January 2019 to November 2021 were selected for high-resolution CT,tumor markers and pathological examination.Taking the results of histopathological examination as the gold standard,the differences of CT signs and tumor marker levels between benign and malignant nodules were compared,and the clinical value of CT combined with tumor marker detection in differentiating benign and malignant solitary pulmonary nodules was analyzed by receiver operating characteristic curve(ROC).Results Pathological examination showed that among 70 patients,there were 39 malignant nodules and 31 benign nodules.There was no statistical difference between benign group and malignant group in terms of age,nodule diameter and sex(P>0.05).The detection rates of typical nodules with deep lobulation,pleural depression,short and fine burrs,polycystic shadows,bronchial vascular convergence sign and spinous processes in group B were higher than those in benign group,and the detection rates of adjacent pleural thickening and satellite lesions in benign group were higher than those in malignant group,with statistical significance(P<0.05).Serum squamous cell carcinoma antigen(SCC),nerve-specific enolase(NSE),cytokeratin 19 fragment(CYFRA-21)and carcinoembryonic antigen(CEA)in malignant group were higher than those in benign group,with statistical significance(P<0.05).The sensitivity,specificity and accuracy of CT in differential diagnosis of solitary pulmonary nodules were 74.36%,87.10%and 80.00%,respectively.The sensitivity,specificity and accuracy of tumor markers in differential diagnosis of solitary pulmonary nodules were 87.18%,51.61%and 71.43%,respectively.ROC curve showed that the area under the curve(AUC)of CT combined with tumor markers in differentiating benign and malignant solitary pulmonary nodules was 0.841,and the s

关 键 词：体层摄影术 X线计算机 肿瘤标志物 孤立性肺结节 鉴别诊断 

分 类 号：R814.4[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]