CT后处理征象联合外周血清癌胚抗原在肺腺癌病变发展中的鉴别作用  

The diagnosis role of CT post-processing signs combined with peripheral serum CEA level in the development of lung adenocarcinoma

作　　者：张华锋[1] 竺王玉 乐涵波 ZHANG Huafeng;ZHU Wangyu;LE Hanbo(Department of Thoracic Surgery,Zhoushan Hospital,Zhejiang University,Zhoushan 316021,China;不详)

机构地区：[1]浙江大学舟山医院胸心外科,316021 [2]浙江大学舟山医院细胞分子生物实验室,316021

出　　处：《浙江医学》2023年第11期1146-1151,I0007,共7页Zhejiang Medical Journal

基　　金：舟山市科技计划项目(2018C11043)。

摘　　要：目的探讨CT后处理征象联合外周血清癌胚抗原(CEA)在肺腺癌病变发展中的鉴别作用。方法选取2017年1月至2022年2月在浙江大学舟山医院行CT后处理技术和肺癌根治术的患者170例,分析患者CT后处理征象、临床病理特征、术前血清CEA水平与肺腺癌病变发展的关系。结果170例肺腺癌患者中,浸润前病变28例,浸润性病变142例。单因素logistic回归分析显示与浸润前病变比较,浸润性病变的CT影像学结节最大径较大,以混合磨玻璃结节及实性结节居多,可出现分叶征、胸膜凹陷牵拉征,且血清CEA水平较高,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,影像学结节最大径、混合磨玻璃结节和实性结节是肺腺癌浸润性病变的独立影响因素(均P<0.05)。ROC曲线分析显示,CT后处理征象联合外周血清CEA预测值用于鉴别肺腺癌浸润性病变的AUC为0.913,灵敏度为0.923,特异度为0.821,明显高于影像学结节最大径和结节类型(均P<0.05)。结论CT后处理征象联合外周血清CEA可用于鉴别肺腺癌浸润前病变和浸润性病变,值得推广应用。Objective To investigate the diagnostic value of CT post-processing signs combined with peripheral serum CEA in the progression of lung adenocarcinoma after resection.Methods A total of 170 patients with lung adenocarcinoma who underwent radical resection in Zhoushan Hospital,Zhejiang University from January 2017 to February 2022 were enrolled.The relationship of the progression of lung adenocarcinoma with CT post-processing signs and preoperative serum CEA levels of patients were analyzed.Results Among 170 patients,there were 28 cases of preinvasive lesions and 142 cases of invasive lesions.Univariate logistic regression analysis showed that compared to preinvasive lesions,the maximum diameter of CT imaging of invasive lesions was larger with higher rate of mixed ground glass nodules and solid nodules,lobulation signs,pleural depressions,and traction sign;and patients with invasive lesions had higher serum CEA levels(P<0.05).Multivariate Logistic regression analysis showed that the maximum diameter of CT imaging,the mixed ground glass nodules and solid nodules were independent risk factors for invasive lesions of lung adenocarcinoma(P<0.05).The area under receiver operating curve(AUC)of CT post-processing signs combined with CEA in diagnosing invasive lesions of lung adenocarcinoma was 0.913 with a sensitivity of 0.923 and a specificity of 0.821,which were significantly higher than that of the maximum image diameter,mixed ground glass nodules and solid nodules,respectively(P<0.05).Conclusion CT post-processing signs combined with CEA can be used to identify preinvasive lesions and invasive lesions of lung adenocarcinoma,which is worthy of popularization and application.

关 键 词：CT 肺腺癌 癌胚抗原 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]