摘要
目的研究中央型肺癌多层螺旋CT(multi-slice spiral CT,MSCT)影像学特征及与癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白片段21-1(cytokeratin fragment 21-1,CYFRA21-1)、糖链抗原242(carbohydrate antigen,CA242)的联合诊断价值。方法收集本院132例疑似中央型肺癌患者的临床资料,分析病理诊断结果及CT特征;比较良恶性疾病与不同类别肺癌血清CEA、CYFRA21-1及CA242水平。并分析MSCT联合肿瘤标志物CEA、CYFRA21-1及CA242诊断中央型肺癌的价值。结果①经病理诊断,132例疑似中央型肺癌患者确诊为恶性69例,其中小细胞肺癌25例,非小细胞肺癌(包括腺癌与鳞癌)44例。良性病变63例。②中央型肺癌影像学特征:CT扫描可见不规则或类圆形肺门区肿块;肿块呈分叶征,边缘脐凹样改变肺门影增大、增浓;支气管管壁增厚、管腔狭窄;支气管截断征;增强扫描呈轻中度强化,强化多不均匀。③良性病变血清CEA、CYFRA21-1及CA242水平及阳性表达率均显著低于恶性病变(P<0.05);小细胞肺癌者CYFRA21-1及CA242水平显著低于非小细胞肺癌者(P<0.05)。受试者工作特征曲线(ROC)分析结果:MSCT、CEA、CYFRA21-1及CA242单项及联合检测中,以联合检测曲线下面积更大。结论中央型肺癌患者CEA、CYFRA21-1及CA242水平呈高表达状态,且上述因子联合MSCT检查可有效提供中央型肺癌诊断准确率。
Objective To study the imaging features of multi-slice spiral CT(MSCT)of central lung cancer and the diagnostic value of it combined with carcinoembryonic antigen(CEA),cytokeratin fragment 21-1(CYFRA21-1)and carbohydrate antigen 242(CA242).Methods The clinical data of 132 patients with suspected central lung cancer were collected in our hospital,and the results of pathological diagnosis and CT characteristics were analyzed.The serum CEA,CYFRA21-1 and CA242 levels in benign and malignant diseases and different types of lung cancer were compared.The value of MSCT combined with tumor markers CEA,CYFRA21-1 and CA242 in the diagnosis of central lung cancer was analyzed.Results①After pathological diagnosis,among 132 patients with suspected central lung cancer,69 were diagnosed as malignant lesions,including 25 with small cell lung cancer and 44 with non-small cell lung cancer(including adenocarcinoma and squamous cell carcinoma),63 were diagnosed as benign lesions.②Imaging features of central lung cancer:irregular or round hilar masses could be seen in CT Scan.The mass showed a lobular sign,umbilical concave-like changes at the edge,and hilar shadows were enlarged and thickened.The wall of the bronchus was thickened and the lumen was narrow.There was a bronchus truncation sign.The enhanced scan showed mild to moderate enhancement,and the enhancement was uneven.③Serum CEA,CYFRA21-1 and CA242 levels and positive expression rates of benign lesions were significantly lower than those of malignant lesions(P<0.05).The levels of CYFRA21-1 and CA242 in patients with small cell lung cancer were significantly lower than those in patients with non-small cell lung cancer(P<0.05).The results of ROC curve analysis showed that the area under the curve of the combined detection of MSCT,CEA,CYFRA21-1 and CA242 was larger in single detection and combined detection.Conclusion The levels of CEA,CYFRA21-1 and CA242 in patients with central lung cancer are highly expressed,and the combination of the above factors and MSCT examination
作者
崔逐云
卫佳佳
田艳
刘学
Cui Zhuyun;Wei Jiajia;Tian Yan;Liu Xue(Department of Imaging,Jiyuan people′s Hospital,Henan 459000,China)
出处
《实用医学影像杂志》
2022年第2期148-151,共4页
Journal of Practical Medical Imaging
