低剂量螺旋CT联合肿瘤标志物在肺癌高危人群筛查中的价值  

Application Value of Low-Dose Spiral CT Combined with Tumor Markers in the Screening of High-Risk Populations for Lung Cancer

作　　者：王彪 董亚锋 马雯 边淼 WANG Biao;DONG Yafeng;MA Wen;BIAN Miao(Medical Imaging Department,the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450008,China;Health Management Center,the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院医学影像科,河南郑州450008 [2]郑州大学附属肿瘤医院/河南省肿瘤医院健康管理中心,河南郑州450008

出　　处：《河南医学研究》2025年第4期636-640,共5页Henan Medical Research

摘　　要：目的探讨低剂量螺旋CT(LDCT)联合血清肿瘤标志物胃泌素释放肽前体(Pro-GRP)、神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、血清癌胚抗原(CEA)在早期肺癌筛查中的价值。方法选取2021年3月至2023年3月在河南省肿瘤医院接受LDCT检查的146例疑似肺癌病例,根据病理诊断结果分为肺癌组(114例)、良性病变组(32例),分析两组对象的血清肿瘤标志物水平、CT表现征象以及二者联合在早期肺癌诊断中的准确性。结果LDCT诊断肺癌的准确率为70.55%,灵敏度为69.35%,特异度为81.82%。肺癌和良性病变的影像学征象如结节分类、分叶征、毛刺征、胸膜凹陷征在两组之间的差异有统计学意义(P<0.05)。肺癌组的血清肿瘤标志物水平高于良性病变组(P<0.05)。受试者工作特征(ROC)曲线分析显示LDCT联合血清肿瘤标志物诊断早期肺癌的AUC为0.850,敏感度、特异度及准确率分别为85.9%、81.25%和84.25%,均高于各指标单独诊断。结论低剂量螺旋CT联合血清肿瘤标志物对早期肺癌的诊断价值较高。Objective To investigate the value of low-dose spiral computed tomography(LDCT)combined with serum tumor markers progastrin-releasing peptide(Pro-GRP),neuron-specific enolase(NSE),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1),serum carcinoembryonic antigen(CEA)in early lung cancer screening.Methods A total of 146 suspected lung cancer cases undergoing LDCT scans at Henan Cancer Hospital from March 2021 to March 2023 were included.Based on pathological diagnosis results,they were divided into lung cancer group(114 cases)and benign lesion group(32 cases).The levels of serum tumor markers,CT imaging findings,and the accuracy of their combined use in early lung cancer diagnosis were compared and analyzed between the two groups.Results The accuracy,sensitivity,and specificity of LDCT in diagnosing lung cancer are 70.55%,69.35%,and 81.82%,respectively.The differences in imaging features such as nodule classification,lobulation,spiculation,and pleural indentation between lung cancer and benign lesions were statistically significant between the two groups(P<0.05).The serum tumor marker levels in the lung cancer group were higher than those in the benign lesion group(P<0.05).ROC curve analysis showed that the AUC of LDCT combined with serum tumor markers for the diagnosis of early lung cancer was 0.850,with sensitivity,specificity,and accuracy of 85.9%,81.25%,and 84.25%,respectively,all higher than the diagnosis of each indicator alone.Conclusion Low-dose spiral CT combined with serum tumor markers has high diagnostic value for early lung cancer.

关 键 词：早期肺癌 低剂量螺旋CT 肿瘤标志物 诊断价值 

分 类 号：R734.2[医药卫生—肿瘤]