低剂量CT联合外周血循环肿瘤细胞在肺癌早期诊断中的价值研究  

Value of Low Dose CT Combined with Peripheral Blood Circulating Tumor Cells in Early Diagnosis of Lung Cancer

作　　者：蒋浩 曹新超 吴桐 郭志斌 JIANG Hao;CAO Xin-chao;WU tong;GUO Zhi-bin(Department of Thoracic Surgery,Cangzhou People's Hospital,Cangzhou 061000,Hebei Province,China)

机构地区：[1]沧州市人民医院胸外科,河北沧州061000

出　　处：《中国CT和MRI杂志》2024年第6期57-60,共4页Chinese Journal of CT and MRI

基　　金：Myrian影像后处理系统在早期肺癌诊断中的应用研究(162777231)。

摘　　要：目的 探究低剂量CT联合外周血循环肿瘤细胞(CTC)在肺癌早期诊断中的价值。方法 选取2019年12月~2022年12月期间本院收治的75例早期肺癌患者,作为肺癌组,同期选取于本院进行治疗的59例肺部良性病变患者为对照组,收集两组患者的临床资料。所有患者均进行低剂量CT扫描,并检测CTC水平,Logistic回归分析明确影响肺癌发生的因素,根据受试者工作特征(ROC)曲线分析低剂量CT与CTC检测对肺癌早期诊断的预测价值。结果 肺癌组有分叶征、毛刺征及胸膜凹陷征人数均高于对照组(P<0.05);肺癌组有吸烟史、CTC阳性人数均高于对照(P<0.05);经Logistic回归分析,有吸烟史、毛刺征、胸膜凹陷征及CTC阳性是影响肺癌发生的独立危险因素(P<0.05);经RDC分析显示,分叶征诊断肺癌早期的AUC值为0.747,95%CI为0.664~0.818;胸膜凹陷征的AUC值为0.789,95%CI为0.710~0.854,CTC预测的AUC值为0.840,95%CI为0.767-0.898,三者联合预测的AUC值为0.878,95%CI为0.811~0.928。结论 低剂量CT表现中分叶征、胸膜凹陷征及CTC对于肺癌早期诊断均有一定的参考价值,三者联合用于肺癌的早期诊断具有更高的价值。Objective To explore the value of low dose CT combined with peripheral blood circulating tumor cells(CTCS) in the early diagnosis of lung cancer.Methods 75 patients with early stage lung cancer admitted to our hospital from December 2019 to December 2022 were selected as lung cancer group.In the same period,59 patients with benign lung lesions treated with our hospital were selected as the control group.Clinical data of patients in both groups were collected.All patients underwent low-dose CT scanning and CTC levels were detected.Logistic regression analysis was performed to determine the factors affecting the occurrence of lung cancer,and the predictive value of low-dose CT and CTC detection in the early diagnosis of lung cancer was analyzed according to receiver operating cha racteristic(ROC) cu rve.Results The number of patients with lobular sign,burr sign and pleural sag sign in lung cancer group was higher than that in control group(P<0.05).The number of patients with smoking history,positive low-dose CT and positive CTCS in lung cancer group was higher than that in control group(P<0.05).Logistic regression analysis showed that smoking history,positive burr sign,pleural depression sign and positive CTCS were independent risk factors for lung cancer(P<0.05).ROC analysis showed that the value of AUC for diagnosing early lung cancer was 0.747 and 95%CI was 0.664~0.818.The AUC value of pleural depression sign was 0.789,and 95%CI was 0.710-0.854.The AUC value predicted by CTC was 0.840,and 95%CI was 0.767-0.898.The combined predicted AUC value was 0.878,and 95%CI was 0.811-0.928.Conclusion The low-dose CT findings of lobular sign,pleural depression sign and CTC are of certain reference value for the early diagnosis of lung cancer,and the combination of the three is of higher value for the early diagnosis of lung cancer.

关 键 词：肺癌 低剂量CT 外周血循环肿瘤细胞 早期诊断 

分 类 号：R734.2[医药卫生—肿瘤]