低剂量螺旋CT联合血清肺癌自身抗体在肺癌早期诊断中的临床应用  

Clinical application of low dose spiral CT combined with serum lung cancer autoantibody in early diagnosis of lung cancer

作　　者：高院 宋延峰[2] 张晓艳[3] 赵雪艳[4] 高辉[1] Gao Yuan;Song Yanfeng;Zhang Xiaoyan;Zhao Xueyan;Gao Hui(Department of Respiratory and Critical Care Medicine,Yanan People's Hospital,Shaanxi Province,Yanan 716000,China;不详)

机构地区：[1]陕西省延安市人民医院呼吸与危重症医学科,716000 [2]陕西省延安市人民医院CT诊断室,716000 [3]陕西省延安市人民医院检验科,716000 [4]陕西省延安市人民医院病理科,716000

出　　处：《疑难病杂志》2023年第1期36-41,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省自然科学基础研究计划项目(2022JM-583)。

摘　　要：目的 分析低剂量螺旋CT(LDCT)联合血清肺癌自身抗体在肺癌早期诊断中的价值。方法 选取2020年8月—2022年8月延安市人民医院呼吸与危重症医学科收治肺癌患者120例为肺癌组,另选取同期医院收治肺部良性病变患者46例为对照组,均进行LDCT扫描,采用酶联免疫吸附法检测血清肺癌7项肿瘤相关自身抗体[7-TAAB,包括p53、蛋白基因产物9.5(PGP9.5)、SRY盒转录因子2(SOX2)、G抗原7(GAGE7)、ATP结合RNA解旋酶(GBU4-5)、黑色素瘤抗原A1(MAGE A1)、肿瘤相关基因(CAGE)]水平。采用受试者工作特征曲线(ROC)分析LDCT联合血清7-TAAB在肺癌早期诊断中的价值。结果 肺癌组CT征象中磨玻璃结节、支气管充气征、空泡征、胸膜凹陷征、毛刺征、分叶征比例高于对照组(χ^(2)/P=5.743/0.017、8.260/0.004、7.275/0.007、11.499/0.001、14.118/<0.001、11.474/0.001)。166例患者中,LDCT诊断肺癌阳性病例114例、阴性病例52例,24例肺癌误诊为良性病变,28例肺部良性病变误诊为肺癌。肺癌组血清p53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGE A1、CAGE水平均高于对照组(Z=5.168、4.170、4.660、4.561、4.039、5.528、4.981,P均<0.001)。肺癌组血清p53、SOX2、GAGE7、MAGE A1、CAGE、7-TAAB阳性率高于对照组(χ^(2)/P=18.669/<0.001、9.114/0.005、13.676/<0.001、12.377/<0.001、6.794/0.009、27.041/<0.001)。LDCT、血清7-TAAB及二者联合诊断早期肺癌的曲线下面积分别为0.704、0.725、0.886,LDCT联合7-TAAB诊断效能高于单项指标(Z=4.000、4.184,P均<0.001)。结论 LDCT联合血清肺癌自身抗体对肺癌早期诊断的价值较高。Objective To analyze the value of low-dose spiral CT(LDCT) combined with serum lung cancer autoantibodies in early diagnosis of lung cancer. Methods From August 2020 to August 2022, 120 patients with lung cancer were selected as the lung cancer group in the Department of Respiratory and Critical Care Medicine of Yan’an People’s Hospital, and 46 patients with benign lung diseases in the same period were selected as the control group. LDCT scanning was performed on all patients. Seven tumor related autoantibodies [7-TAAB, including p53, protein gene product 9.5(PGP9.5), SRY box transcription factor 2(SOX2), G antigen 7(GAGE7) ATP binding RNA helicase(GBU4-5), melanoma antigen A1(MAGE A1), tumor associated gene(CAGE)] levels. The value of LDCT combined with serum 7-TAAB in the early diagnosis of lung cancer was analyzed by subject operating characteristic curve(ROC). Results The proportion of ground glass nodule, air bronchogram sign, vacuole sign, pleural indentation sign, spiculation sign and lobulation sign in the lung cancer group was higher than that in the control group(χ^(2)/P=5.743/0.017,8.260/0.004,7.275/0.007,11.499/0.001,14.118/<0.001,11.474/0.001).Among 166 patients, 114 cases were diagnosed as lung cancer positive by LDCT, 52 cases were diagnosed as lung cancer negative, 24 cases were misdiagnosed as benign lesions, and 28 cases were misdiagnosed as lung cancer benign lesions. Serum p53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGE A1, CAGE levels in lung cancer group were higher than those in control group(Z=5.168, 4.170, 4.660, 4.561, 4.039, 5.528, 4.981, P<0.001). The positive rates of serum p53, SOX2, GAGE7, MAGE A1, CAGE, 7-TAAB in lung cancer group were higher than those in control group(χ^(2)/P=18.669/<0.001, 9.114/0.005, 13.676/<0.001,12.377/<0.001, 6.794/0.009, 27.041/<0.001). The area under the curve of LDCT, serum 7-TAAB and their combination in diagnosing early lung cancer were 0.704, 0.725 and 0.886, respectively. The diagnostic efficacy of LDCT combined with 7-TAAB was higher than that of singl

关 键 词：肺癌 低剂量螺旋CT 自身抗体 早期诊断 

分 类 号：R734.2[医药卫生—肿瘤]