胸部低剂量CT扫描联合血清MIC-1、sMICA对NSCLC的诊断分析  

Diagnosis of NSCLC Using Low-dose Chest CT Scan Combined with Serum MIC-1 and sMICA

作　　者：王英 严秋月 何远强 WANG Ying;YAN Qiu-yue;HE Yuan-qiang(Department of Respiratory and Critical Care Medicine,The Affiliated Huai'an Hospital of Xuzhou Medical University,Huai'an Second People's Hospital,Huai'an 223002,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属淮安医院(淮安市第二人民医院)呼吸与危重症医学科,江苏淮安223002

出　　处：《中国CT和MRI杂志》2025年第3期71-74,共4页Chinese Journal of CT and MRI

摘　　要：目的探究胸部低剂量CT扫描联合血清巨噬细胞抑制因子-1(MIC-1)、可溶性MHC-Ⅰ类链相关分子A(sMICA)对非小细胞肺癌(NSCLC)的诊断分析。方法回顾性分析本院2023年1月至2024年1月收治的89例疑似NSCLC患者,经病理诊断NSCLC 63例,良性病变26例。比较NSCLC患者和良性病变患者的胸部低剂量CT、血清MIC-1、sMICA的检测结果,单一胸部低剂量CT、血清MIC-1、sMICA对NSCLC诊断价值,及联合诊断价值。结果NSCLC患者血容量(BV)、强化峰值(PEI)高于良性病变患者,对比剂达峰时间(TTP)低于良性病变患者(P<0.05);NSCLC患者的血清MIC-1、sMICA水平均高于良性病变患者(P<0.05);单一胸部低剂量CT、血清MIC-1、sMICA诊断NSCLC时,以BV的曲线下面积(AUC)值最高,以9.7 mL/100 g为最佳截断值,BV诊断NSCLC的敏感度、特异度分别为76.19%、96.15%;以二元Logistic回归分析构建联合诊断模型,联合诊断NSCLC的AUC为0.969,以0.47为最佳截断值,联合诊断NSCLC的敏感度、特异度分别为92.06%、92.31%。结论胸部低剂量CT参数BV、PEI、TTP与血清MIC-1、sMICA均可用于NSCLC的临床诊断,其中BV诊断效能最佳,胸部低剂量CT扫描联合血清MIC-1、sMICA则可进一步提升诊断敏感度,值得推广。Objective To investigate the diagnostic value of low-dose chest CT scan combined with serum macrophage inhibitory cytokine-1(MIC-1)and soluble major histocompatibility complex class I chainrelated peptide A(sMICA)for non-small cell lung cancer(NSCLC).Methods A total of 89 patients who were suspected of NSCLC and admitted to the hospital from January 2023 to January 2024 were reviewed.Pathological diagnosis revealed 63 cases of NSCLC and 26 cases of benign lesions.The detection results of low-dose chest CT,serum MIC-1 and sMICA were compared between patients with NSCLC and patients with benign lesions.The diagnostic value of low-dose chest CT,serum MIC-1,sMICA,and their combination for NSCLC was evaluated.Results Blood volume(BV)and peak enhancement intensity(PEI)in patients with NSCLC were higher than those in patients with benign lesions,and time to peak(TT P)of contrast agent was shorter than that in patients with benign lesions(P<0.05).Serum MIC-1 and sMICA levels in patients with NSCLC were higher than those in patients with benign lesions(P<0.05).For separate diagnosis of NSCLC,the area under the curve(AUC)of BV was the largest.When the optimal cutoff value was 9.7 mL/100 g,the sensitivity and specificity of BV for diagnosing NSCLC were 76.19%and 96.15%.A joint diagnosis model was constructed based on binary logistic regression analysis,and the AUC of joint diagnosis of NSCLC was 0.969.When the optimal cutoff value was 0.47,the sensitivity and specificity of joint diagnosis of NSCLC were 92.06%and 92.31%.Conclusion Low-dose chest CT parameters(BV,PEI and TT P)and serum MIC-1 and sMICA can all be used for clinical diagnosis of NSCLC,and BV has the best diagnostic efficacy.Combined use of them can improve diagnostic sensitivity.

关 键 词：非小细胞肺癌 胸部低剂量CT 血清生物标志物 诊断 

分 类 号：R563[医药卫生—呼吸系统]