高分辨率CT联合肺癌血清肿瘤标志物检测对早期肺癌的诊断价值

目的探究高分辨率CT（HRCT）联合血清肿瘤标志物检测对早期肺癌的诊断价值。方法选取2016年3月~2019年11月本院80例早期肺癌患者作为肺癌组，同期选取80例肺良性病变者作为良性组。所有患者均进行HRCT检查及肺癌血清标志物（癌胚抗原、CA125、神经元特异性烯醇化酶、细胞角蛋白19片段）检测，比较两组HRCT影像结果及血清标志物水平，以病理结果为金标准，分析HRCT、血清标志物及二者联合检查的诊断效能。结果肺癌组与良性组影像特征中分叶征、毛刺征、界面、囊状透亮影比较差异有统计学意义（P < 0.05），肺癌组血清癌胚抗原、CA125、神经元特异性烯醇化酶、细胞角蛋白19片段水平均高于良性组（P < 0.05）。以病理结果为金标准，HRCT单独诊断肺癌灵敏度、特异度、准确度分别为75.00%、92.50%、83.75%，血清标志物分别为85.00%、78.75%、81.75%，二者联合分别为96.25%、77.50%、86.87%；HRCT、血清肿瘤标志物及联合检测诊断早期肺癌的受试者工作特征曲线下面积分别为0.838、0.819、0.875（P < 0.001）。结论HRCT与肺癌血清标志物对早期肺癌均有一定诊断价值，且二者联合检查能进一步提高诊断灵敏度及准确度，值得临床应用。 

Diagnostic value of high-resolution CT combined with detection of lung cancer serum tumor markers in early lung cancer

ObjectiveTo explore the diagnostic value of high-resolution CT (HRCT) combined with detection of serum tumor markers on early lung cancer.MethodsFrom March 2016 to November 2019, 80 patients with early lung cancer and 80 patients with benign lung lesions in the hospital were selected. HRCT examination and detection of lung cancer serum markers carcinoembryonic antigen (CEA), carbohydrate antigen CA 125, neuron-specific enolase (NSE), cytokeratin 19 fragment (CYFRA21-1)] were performed on all patients. The HRCT imaging results and serum markers levels were compared between the two groups. The pathological results were taken as the gold standards to analyze the diagnostic efficacy of HRCT, serum markers and the combination of the two.ResultsThe differences of the imaging features of lobulation sign, spicule sign, interfaces and cystic lucency shadow between lung cancer group and benign group were significant (P < 0.05). The levels of serum CEA, CA125, NSE and CYFRA21-1 in lung cancer group were significantly higher than those in benign group (P < 0.05). With the pathological results as the gold standards, the sensitivity, specificity and accuracy of HRCT in the diagnosis of lung cancer were75.00%, 92.50% and 83.75%, the above indexes of serum markers were 85.00%, 78.75% and 81.75% respectively, and above indexes of the combination of the two were 96.25%, 77.50% and 86.87%. The values of area under the receiver operating characteristic curve (ROC curve) of HRCT, serum tumor markers and combined detection of early lung cancer were 0.838, 0.819 and 0.875(P < 0.001).ConclusionHRCT and lung cancer serum markers have certain diagnostic value on early lung cancer. The combined examination of the two can further improve the diagnostic sensitivity and accuracy.