探讨高分辨率CT联合血清CEA、NSE、SCCA水平在周围型肺癌诊断中的应用  

Application of High Resolution CT Combined with Serum CEA,NSE and SCCA Levels in the Diagnosis of Peripheral Lung Cancer

作　　者：金洁琼 孙丽娜 刘中文 JIN Jie-qiong;SUN Li-na;LIU Zhong-wen(Department of Medical Imaging,Special Medical Center of Armed Police Force,Tianjin 300171,China)

机构地区：[1]武警特色医学中心医学影像科,天津300171

出　　处：《中国CT和MRI杂志》2024年第11期50-52,共3页Chinese Journal of CT and MRI

基　　金：国家自然科学基金重点项目(11932013)。

摘　　要：目的探讨高分辨率CT(HRCT)联合血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)水平在周围型肺癌(PLC)诊断中的应用。方法选取并调查2021年6月至2023年6月在我院进行诊治的肺部占位性病变患者82例,以病理学检查结果为金标准,经病理学检查及细胞学检查结果将其分为恶性病变组(n=48)和良性病变组(n=34)。所有患者均进行HRCT检查并测定血清肿瘤标志物水平。比较两组基础资料信息,采用多因素Logistic回归分析影响PLC发生的危险因素,绘制ROC曲线评价血清CEA、NSE、SCCA水平及联合HRCT诊断PLC的效能。结果恶性病变组分叶征、毛刺征、囊状透亮影占比、血清CEA、NSE、SCCA水平数据显著高于良性病变组(P<0.05)。多因素Logistic回归分析结果显示有分叶征、有毛刺征、有囊状透亮影、CEA增高、NSE增高、SCCA增高是PLC发生的危险因素(P<0.05)。经ROC分析证实,血清CEA、NSE、SCCA含量诊断肺癌的AUC分别为0.856、0.881、0.902,联合诊断的AUC为0.942,均有P<0.05。以血清CEA>4.916ng/mL、NSE>17.516ng/mL、SCCA>4.226μg/mL时,发生PLC风险越高。结论PLC患者血清CEA、NSE、SCCA水平较高,且血清CEA、NSE、SCCA水平与HRCT检查联合诊断具有较高的诊断价值,可为PLC患者诊治提供更为可靠的依据。Objective To investigate the application of high-resolution CT(HRCT)combined with serum carcinoembryonic antigen(CEA),neuron-specific enolase(NSE)and squamous cell carcinoma antigen(SCCA)in the diagnosis of peripheral lung cancer(PLC).Methods A total of 82 patients with space-occupying lung lesions who were treated in our hospital from June 2021 to June 2023 were selected and investigated.Based on the pathological examination results as the gold standard,they were divided into the malignant lesion group(n=48)and the benign lesion group(n=34)according to the pathological and cytological examination results.All patients were examined by HRCT and serum tumor marker levels were measured.The basic data of the two groups were compared,and the risk factors affecting PLC were analyzed by multi-factor Logistic regression.ROC curve was drawn to evaluate the serum CEA,NSE,SCCA levels and the combined HRCT diagnostic efficacy of PLC.Results The percentage of leaf sign,burr sign,cystic transparent shadow,serum CEA,NSE and SCCA in malignant lesion were significantly higher than those in benign lesion group(P<0.05).Multivariate Logistic regression analysis showed that the risk factors of PLC were segmentation,burr,cystic light,CEA,NSE and SCCA(P<0.05).ROC analysis confirmed that the AUC of serum CEA,NSE and SCCA content in the diagnosis of lung cancer was 0.856,0.881 and 0.902,respectively,and the AUC of combined diagnosis was 0.942,all with P<0.05.When the serum CEA>4.916 ng/mL,NSE>17.516 ng/mL,SCCA>4.226μg/mL,the risk of PLC was higher.Conclusion PLC patients have higher serum CEA,NSE and SCCA levels,and the combined diagnosis of serum CEA,NSE and SCCA levels with HRCT examination has higher diagnostic value,which can provide a more reliable basis for the diagnosis and treatment of PLC patients.

关 键 词：周围型肺癌 高分辨率CT 肿瘤标志物 癌胚抗原 神经元特异性烯醇化酶 鳞状细胞癌抗原 

分 类 号：R73[医药卫生—肿瘤]