能谱CT最佳单能图像与肿瘤标志物联合检测在周围型肺癌患者临床诊断中的应用

目的:探析能谱CT最佳单能图像联合血清CEA、NSE、CYFRA21-1、SCCA检测在周围型肺癌（PLC）诊断中的应用价值。方法:选取中国医科大学附属第一医院2019年1月~2020年1月收治的240例疑似PLC患者为研究对象。患者入院后均行CT检查及血清肿瘤标志物检测，测定CEA、NSE、CYFRA21-1、SCCA水平。以病理结果为PLC判定的金标准，评价CT联合血清CEA、NSE、CYFRA21-1、SCCA检测在PLC诊断中的应用价值。结果:疑似PLC患者中恶性病变130例，良性病变110例。恶性病变组的CEA、NSE、CYFRA21-1、SCCA水平显著高于良性病变组（P<0.001）；腺癌患者的CEA、CYFRA21-1、SCCA水平与鳞癌患者相比存在统计学差异（P<0.001）；CT联合肿瘤标志物检测的敏感度和特异性显著优于血清肿瘤标志物检测或CT检查（P<0.001）。结论:能谱CT最佳单能图像联合血清CEA、NSE、CYFRA21-1、SCCA检测诊断PLC的价值较高，其准确度高于单一检测。

Application of the optimal monoenergetic images in energy spectral CT combined with tumor markers detection in diagnosing peripheral lung cancer

Abstract: Objective To analyze the application value of the optimal monoenergetic image in energy spectral CT combined with the detections of serum CEA, NSE, CYFRA21-1 and SCCA in the diagnosis of peripheral lung cancer (PLC). Methods A total of 240 patients with suspected PLC admitted to the First Hospital of China Medical University from January 2019 to January 2020 were enrolled in the study. After admission, the patients underwent CT examinations, and their serum tumor markers such as CEA, NSE, CYFRA21-1 and SCCA were detected. Taking pathological results as the gold standard for PLC diagnosis, the application value of energy spectral CT combined with the detections of serum CEA, NSE, CYFRA21-1, SCCA in the diagnosis of PLC was evaluated. Results Among the suspected PLC patients, there were 130 malignant lesions and 110 benign lesions. The levels of CEA, NSE, CYFRA21-1 and SCCA in malignant lesion group were significantly higher than those in benign lesion group (P<0.001). Moreover, statistical differences were found in the levels of CEA, CYFRA21-1 and SCCA between adenocarcinoma group and squamous cell carcinoma group (P<0.001) and the sensitivity and specificity of energy spectral CT combined with tumor markers detection were significantly better than those of serum tumor markers detection or CT examination alone (P<0.01). Conclusion The optimal monoenergetic image in energy spectral CT combined with the detections of serum CEA, NSE, CYFRA21-1 and SCCA is of high value in the diagnosis of PLC, and its accuracy is higher than that of a single detection.