摘要
目的探究孤立性肺结节的高分辨率CT(HRCT)征象与肿瘤标志物的相关性及联合鉴别良恶性的效果。方法选取我院2021年2月~2023年1月期间收治的SPN患者86例作为研究对象,均行HRCT检查,以穿刺活检作金标准,比较良恶性结节患者HRCT征象、肿瘤标志物,分析HRCT诊断价值以及征象和肿瘤标志物联合诊断价值。结果86例SPN患者的病理结果为:阳性者61例,阴性者25例;HRCT诊断敏感性、特异性、准确性、阳性预测值、阴性预测值分别为80.33%、60.00%、74.42%、83.05%、55.56%;良性患者毛刺征、血管集束征、胸膜牵拉征、分叶征发生率以及血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、鳞状上皮细胞癌抗原(SCC)、神经元特异性烯醇化酶(NSE)水平少于恶性患者(P<0.05);ROC曲线显示,HRCT征象联合血清CYFRA21-1、NSE、SCC、CEA水平诊断SPN患者良恶性的AUC为0.916、最佳诊断敏感性为88.52%、最佳特异性为88.00%(P<0.05)。结论HRCT征象联合血清CYFRA21-1、NSE、SCC、CEA水平在SPN良恶性的诊断中敏感性、特异性较高。
Objective To explore the correlation between high-resolution CT(HRCT)features of solitary pulmonary nodules and tumor markers,and the effectiveness of combined differentiation between benign and malignant.Methods 86 patients with SPN admitted to our hospital from February 2021 to January 2023 were selected as the research subjects.All patients underwent HRCT examination,and puncture biopsy was used as the gold standard to compare the HRCT signs and tumor markers of benign and malignant nodules,and analyze the diagnostic value of HRCT and the combined diagnostic value of signs and tumor markers.Results 86 SPN patients were as follows:61 were positive and 25 were negative;the diagnostic sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of HRCT were 80.33%,60.00%,74.42%,83.05%,and 55.56%,respectively;the incidence of hair prick sign,vascular bundle sign,pleural traction sign,lobulation sign,and serum levels of carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCC),and neuron specific enolase(NSE)in benign patients were lower than those in malignant patients(P<0.05);the serum levels of CYFRA21-1,SCC,NSE,and CEA were positively correlated with lobulation sign,hairpin sign,vascular bundle sign,and pleural traction sign(P<0.05);the ROC curve shows that the AUC of HRCT combined with serum CYFRA21-1,NSE,SCC,and CEA levels in diagnosing benign and malignant SPN patients is O.916,the optimal diagnostic sensitivity is 88.52%,and the optimal specificity is 88.00%(P<0.05).Conclusion The combination of HRCT signs and serum CYFRA21-1,NSE,SCC,and CEA levels is highly sensitive and specific in the diagnosis of benign and malignant SPN.
作者
马秀丽
Ma Xiuli(Yongmei Group General Hospital,Yongcheng City,Henan 476600)
出处
《辽宁医学杂志》
2024年第3期20-24,共5页
Medical Journal of Liaoning
