胸部多层螺旋CT低剂量联合血清S100A10和CST1在早期肺癌中的筛查价值  

Screening Value of Low-dose Chest Multislice Spiral CT Combined with Serum S100A10 and CST1 in Early Lung Cancer

作　　者：王宇[1] 安杨 赵微 褚杨 WANG Yu;AN Yang;Zhao Wei;Chu Yang(Department of Respiratory Diseases,Central Medical Branch of PLA General Hospital,Beijing 100081,China;Department of Respiratory and Critical Care Medicine,the Eighth Medical Center of PLA General Hospital,Beijing 100853,China;Department of Stomatology,Western Medical Branch of PLA General Hospital,Beijing 100144,China)

机构地区：[1]中国人民解放军总医院京中医疗区呼吸科,北京100081 [2]中国人民解放军总医院第八医学中心呼吸与危重症学部,北京100853 [3]中国人民解放军总医院京西医疗区口腔科,北京100144

出　　处：《中国CT和MRI杂志》2024年第11期47-49,共3页Chinese Journal of CT and MRI

基　　金：国家重点研发计划数字诊疗装备研发重点专项课题(2019YFC0120504)。

摘　　要：目的探究胸部多层螺旋CT低剂量联合血清S100钙结合蛋白A10(S100A10),胱抑素SN(CST1)在早期肺癌中的筛查价值。方法选取2018年1月1日至2020年8月31日本院收治的497例肺部结节患者,根据病理诊断结果分为良性病变患者86例,肺癌患者411例。对患者进行胸部多层螺旋CT低剂量扫描,采用ELISA法检测血清S100A10、CST1水平。用ROC曲线分析血清S100A10、CST1水平对早期肺癌的诊断价值;用四格表法分析胸部多层螺旋CT低剂量联合血清S100A10、CST1对早期肺癌的诊断价值。结果肺癌患者血清S100A10、CST1水平高于良性病变患者(P<0.05)。血清S100A10、CST1水平诊断早期肺癌的AUC为0.729、0.707,敏感性为67.64%、53.04%,特异性为69.77%、81.40%。CT低剂量扫描诊断敏感性为89.29%(367/411),特异性为73.26%(63/86),准确度为86.52%(430/497),其诊断结果与术后病理诊断结果具有一致性(Kappa值=0.570,P<0.05)。胸部多层螺旋CT低剂量联合血清S100A10、CST1早期诊断肺癌的敏感性为97.32%(400/411),特异性为67.44%(58/86),准确度为92.15%(458/497),三者联合对早期肺癌的诊断结果与术后病理诊断结果具有较好一致性(Kappa=0.703,P<0.05)。胸部多层螺旋CT低剂量联合血清S100A10、CST1诊断早期肺癌的敏感性和准确度显著高于胸部多层螺旋CT低剂量、S100A10、CST1单独诊断。结论胸部多层螺旋CT低剂量联合血清S100A10、CST1水平诊断早期肺癌的敏感性和准确性较高,三者联合诊断可能对早期肺癌筛查具有重要应用价值。Objective To explore the screening value of low-dose chest multi-slice spiral CT combined with serum S100 calcium binding protein A10(S100A10)and cystatin SN(CST1)in early lung cancer.Methods A total of 497 patients with pulmonary nodules admitted to the hospital from January 1,2018 to August 31,2020 were selected.Based on pathological diagnosis,they were separated into 86 patients with benign lesions and 411 patients with lung cancer.Low-dose chest multi-slice spiral CT scans were performed on patients,ELISA method was applied to detect serum S100A10 and CST1 levels.ROC curve was applied to analyze the diagnostic value of serum S100A10 and CST1 levels for early lung cancer;four grid table method was applied to analyze the diagnostic value of low-dose chest multi-slice spiral CT combined with serum S100A10 and CST1 for early lung cancer.Results The serum S100A10 and CST1 levels in lung cancer patients were higher than those in patients with benign lesions(P<0.05).The AUC of serum S100A10 and CST1 levels for diagnosing early lung cancer was 0.729 and 0.707 respectively,with sensitivity of 67.64%and 53.04%respectively,specificity of 69.77%and 81.40%respectively.The sensitivity of low-dose CT scanning was 89.29%(367/411),specificity was 73.26%(63/86),and accuracy was 86.52%(430/497),the diagnostic results were consistent with postoperative pathological diagnosis(Kappa value=0.570,P<0.05).The sensitivity of low-dose chest multi-slice spiral CT combined with serum S100A10 and CST1 for early diagnosis of lung cancer was 97.32%(400/411),specificity was 67.44%(58/86),and accuracy was 92.15%(458/497),the combination of the three methods showed good consistency between the diagnostic results of early lung cancer and postoperative pathological diagnosis(Kappa=0.703,P<0.05).The sensitivity and accuracy of low-dose chest multi-slice spiral CT combined with serum S100A10 and CST1 in diagnosing early lung cancer were obviously higher than those of low-dose chest multi-slice spiral CT alone.Conclusion Low dose chest multi-slice

关 键 词：胸部多层螺旋CT低剂量 S100钙结合蛋白A10 胱抑素SN 早期肺癌 

分 类 号：R563[医药卫生—呼吸系统]