摘要
目的比较超声与CT引导下经皮肺穿刺活检联合血清肿瘤标志物检测在肺癌诊断中的价值。方法选取我院2017年1月至2018年9月收治的80例拟诊断肺癌患者为研究对象,依据经皮肺穿刺活检术的引导方式不同将以上研究对象分为超声组(32例)和CT组(48例),所有患者均行血清肿瘤标志物检测,评估两种方法的诊断价值;依据病理诊断结果分为恶性组和良性组,比较两组NSE、CY-FRA21-1水平;绘制血清肿瘤标志物诊断肺癌的ROC曲线,分析诊断效能;比较术后6个月超声组与CT组并发症的发生情况。结果80例拟诊断肺癌患者均顺利完成穿刺,成功率100%。经病理学诊断恶性病变患者65例,良性病变患者15例。超声引导经皮肺穿刺活检的灵敏度为0.846,特异度为0.833;CT引导经皮肺穿刺活检的灵敏度为0.923,特异度为0.778。依据病理诊断结果分为恶性组和良性组,恶性组的NSE及CY-FRA21-1水平均显著高于良性组,差异有统计学意义(P<0.05)。NSE诊断肺癌的灵敏度0.738,特异度0.600;CY-FRA21-1诊断肺癌的灵敏度为0.985,特异度为0.533。超声组并发症发生率为15.63%,CT组并发症发生率为14.58%,两组比较差异无统计学意义(P>0.05)。结论超声与CT引导下经皮肺穿刺活检均可作为临床诊断肺癌的重要手段,联合血清肿瘤标志物检测能够显著提高诊断准确性,减少漏诊,临床应结合患者实际病情做出合理选择。
Objective Compare the value of ultrasound and CT-guided percutaneous lung biopsy combined with serum tumor marker detection in the diagnosis of lung cancer.Methods A retrospective analysis was performed on 80 patients with lung cancer diagnosed in our hospital from January 2017 to September 2018.The subjects were divided into ultrasound group( 32 cases) and CT group( 48 cases) according to different guidance methods of percutaneous lung biopsy.Assess the diagnostic value of the two methods.All patients were tested for serum tumor markers. The results of pathological diagnosis were divided into malignant group and benign group,and the NSE and CY-FRA21-1 levels of the two groups were compared.The ROC curve of serum tumor markers for the diagnosis of lung cancer was drawn and the diagnostic efficacy was analyzed.The complications of ultrasound group and CT group were compared 6 months after operation.Results 80 patients with a potential diagnosis of lung cancer were successfully punctured,and the puncture success rate was 100%.Pathologically diagnosed 65 patients with malignant lesions and 15 patients with benign lesions.The sensitivity of ultrasound-guided percutaneous lung biopsy was 0. 846 and the specificity was 0. 833.The sensitivity of CT-guided percutaneous lung biopsy was 0. 923 and the specificity was 0. 778.According to the pathological diagnosis results,they were divided into malignant group and benign group.The levels of NSE and CY-FRA21-1 in the malignant group were significantly higher than those in the benign group,and the difference was statistically significant( P<0. 05).NSE has a sensitivity of 0. 738 and a specificity of 0. 600 for lung cancer.CY-FRA21-1 has a sensitivity of 0. 985 and a specificity of 0. 533 for lung cancer.The complication rate was 15. 63% in the ultrasound group and 14. 58% in the CT group.There was no significant difference between the two groups( P > 0. 05). Conclusion Ultrasound and CT-guided percutaneous lung biopsy can be used as important methods for clinical diagnosis of
作者
严富天
徐泽娟
岳敏
徐汝建
Yan Futian;Xu Zejuan;Yue Min(Department of Ultrasound,Guangyuan Central Hospital,Guangyuan,Sichuan 628000,China)
出处
《四川医学》
CAS
2020年第3期289-293,共5页
Sichuan Medical Journal
基金
广元市指导性科技计划项目(编号:2018ZCRKX009)。
