螺旋计算机X线断层扫描联合肿瘤标志物对肺孤立性结节良恶性的诊断价值  

Diagnostic value of spiral computed tomography combined with tumor markers for the diagnosis of benign and malignant isolated pulmonary nodules

作　　者：冉德水 刘师舜 朱继达 韩真[2] 李锦荣[1] Ran Deshui;Liu Shishun;Zhu Jida;Han Zhen;Li Jinrong(Department of Imaging,Jinan 2ND People′s Hospital,Jinan 250001,China;Department of Internal Medicine,Jinan 2ND People′s Hospital,Jinan 250001,China)

机构地区：[1]济南市第二人民医院影像科,济南250001 [2]济南市第二人民医院内科,济南250001

出　　处：《中国临床实用医学》2023年第4期59-62,共4页China Clinical Practical Medicine

基　　金：济南市卫生健康委员会项目(2020-4-33)。

摘　　要：目的探讨螺旋计算机X线断层扫描(CT)联合肿瘤标志物对肺孤立性结节的鉴别诊断价值。方法本研究为队列研究,选取2019年3月至2021年3月济南市第二人民医院内科收治的81例肺孤立性结节患者,男40例,女41例,年龄(58.2±6.9)岁,年龄范围为42~72岁。根据术后病理结果将所有患者分为良性组(n=56)与恶性组(n=25)。对所有患者行CT检查,并检测癌胚抗原、神经元特异性烯醇化酶(NSE)和鳞癌抗原的水平。结果恶性组患者的磨玻璃或混合密度[60.0%(15/25)]、分叶征[48.0%(12/25)]、空泡征[52.0%(13/25)]、短毛刺征[60.0%(15/25)]、胸膜凹陷征[44.0%(11/25)]、支气管血管集束征[52.0%(13/25)]检出率均高于良性组[14.3%(8/56)、8.9%(5/56)、10.7%(6/56)、7.1%(4/56)、8.9%(5/56)、5.4%(3/56)],差异有统计学意义(P<0.05)。恶性组患者的癌胚抗原[(6.9±2.0)μg/L]、NSE[(17.2±3.8)μg/L]及鳞癌抗原[(1.4±0.6)μg/L]水平均高于良性组[(3.2±0.9)μg/L、(8.8±1.6)μg/L、(0.8±0.2)μg/L],差异有统计学意义(P<0.05)。螺旋CT、癌胚抗原、NSE、鳞癌抗原及联合应用的曲线下面积分别为0.815、0.835、0.712、0.635、0.951。结论肿瘤标志物联合CT对肺孤立性结节的鉴别诊断力高,具有较好的临床应用价值。Objective To investigate the differential diagnostic value of spiral computed tomography(CT)combined with tumor markers for solitary pulmonary nodules.Methods This study was a cohort study,selected 81 patients with solitary pulmonary nodules admitted to the department of Internal Medicine in Jinan Second People′s Hospital from March 2019 to March 2021,including 40 males and 41 females,aged(58.2±6.9)years old,ranging from 42 to 72 years old.According to the postoperative pathological results,all patients were divided into the benign group(n=56)and the malignant group(n=25).All patients were examined by CT,and the levels of carcinoembryonic antigen,neuron specific enolase(NSE)and squamous cell carcinoma antigen were detected.Results The detection rates of ground glass or mixed density[60.0%(15/25)],lobulation sign[48.0%(12/25)],vacuole sign[52.0%(13/25)],short hair prick sign[60.0%(15/25)],pleural indentation sign[44.0%(11/25)],bronchovascular bundle sign[52.0%(13/25)]in the malignant group were higher than those in the benign group[14.3%(8/56),8.9%(5/56),10.7%(6/56),7.1%(4/56),8.9%(5/56),5.4%(3/56)],the differences were statistically significant(P<0.05).Carcinoembryonic antigen[(6.9±2.0)μg/L],NSE[(17.2±3.8)μg/L]and squamous cell carcinoma antigen[(1.4±0.6)μg/L]in the malignant group were higher than that in the benign group[(3.2±0.9)]μg/L,(8.8±1.6)μg/L,(0.8±0.2)μg/L],the differences were statistically significant(P<0.05).The area under the curve of spiral CT,carcinoembryonic antigen,NSE,squamous cell carcinoma antigen and combined application were 0.815,0.835,0.712,0.635 and 0.951.Conclusions The combination of tumor markers and CT has high differential diagnostic power for solitary pulmonary nodules and has good clinical application value.

关 键 词：计算机X线断层扫描 肿瘤标志物 肺孤立性结节 癌胚抗原 神经元特异性烯醇化酶 

分 类 号：R734.2[医药卫生—肿瘤]