摘要
目的:分析肺癌患者术前癌胚抗原(CEA)血清浓度和肿瘤影消失率(TDR)的变化,探讨其在肺癌淋巴结转移中的作用及对肺癌淋巴结廓清的指导意义。方法:选择129例肺切除手术患者作为研究对象,术前采用化学发光免疫分析法测定血清CEA,术前1个月内行胸部CT检查,测量并计算TDR。术中均行系统纵隔淋巴结廓清及肺切除。分析CEA和TDR与肺癌淋巴结转移的关系。结果:CEA阴性、TDR≥0.8对诊断肺腺癌pN0的特异性、阳性预测率(PPV)比由CT中淋巴结大小来判断肺腺癌pN0明显增高。结论:术前CEA测定有助于判断肺癌pN0,TDR水平与肺腺癌淋巴结转移有关。CEA阴性、TDR≥0.8对诊断肺腺癌pN0比由CT中淋巴结大小诊断pN0更有价值,可以用来预测肺腺癌有无淋巴结转移,指导淋巴结廓清。
Objective：To preoperatively investigate serum CEA and TDR （tumor shadow disappearance rate） in patients with lung cancer and to explore their roles in detecting lymphatic metastasis of lung cancer and their purposes in determining lymph-adenectomy, Methods： 129 patients with lung cancer were selected in this study. Their serum CEA was preoperatively assayed with the chemiluminescent immunoassay. In a month before operation, they were all undergone thoracic CT examination to calculate TDR. The operative procedure included systemic mediastinal lymph node dissection and lung resection. Results： There was a significant difference in TDR between lung adenocarcinomas with lymphatic metastasis and without lymphatic metastasis. By using a standard of negative CEA and TDR more than or equal to 0.8, the specificity and PPV （positive predictive value） of diagnosing pNo lung adenocarcinomas were significantly greater than that by using CT to determine lymph node size. Conclusion：The preoperative CEA assay is helpful for diagnosing pNo lung cancer. TDR value is related with lymphatic metastasis of lung adenocarcinoma. The standard of negative CEA and TDR more than or equal to 0.8 is more useful than by using CT to dtermine lymph node size for diagnosing pNo lung adenocarcinoma, and may be used to detect whether lymphatic metastasis of lung adenocarcinoma is developed or not and instruct lymphadenectomy.
出处
《中国临床医学》
北大核心
2008年第1期50-53,共4页
Chinese Journal of Clinical Medicine
关键词
肺癌
癌胚抗原
肿瘤影消失率
淋巴结廓清
阳性预测率
Lung cancer
Carcinoemryomic antigen
Tumor shadow disappearance rate
Lymph node dissection
Positive predictive value
