^99mTc—MIBI肺显像、多排螺旋CT和肿瘤标志物检测对肺癌的诊断价值

目的探讨^99mTc-甲氧基异丁基乙腈（^99mTc-MIBI）亲肿瘤显像、多排螺旋CT、血清肿瘤标志物[癌胚抗原（CEA）、细胞角蛋白19片断（CYFRA21—1）、神经元特异性烯醇化酶（NSE）]检测联合应用对肺癌的诊断价值。方法对350例临床怀疑为肺癌患者的^99mTc-MIBI亲肿瘤显像、多排螺旋CT、血清肿瘤标志物检测资料进行回顾性分析，总结每种方法及三种方法联合应用诊断肺癌的灵敏度、特异度及正确度。350例患者分别经纤维支气管镜检查、手术治疗及穿刺活组织检查、病理最后证实200例为肺癌患者。结果 三种检查方法诊断肺癌的灵敏度、特异度及正确度分别为74．5％（149／200）、68．7％（103／150）、72．0％（252／350），97．5％（195／200）、42．7％（64／150）、74．0％（259／350）及62．5％（125／200）、28．7％（43／150）、48．0％（168／350）。三法联合应用为99．5％（199／200）、82．0％（123／150）、92．0％（322／350）。结论上述三种检查方法对肺癌诊断各有其独特的重要的临床价值，三种方法联合应用诊断价值更大。

Diagnostic value of combination of 99mTc-MIBI imaging,multi-slice spiral CT and tumor marker measurements for lung cancer

Objective To explore the clinical value of the combination of three methods including 99mTc-MIBI imaging, multi-slice spiral CT and tumor markers [carcinoembryonic antigen(CEA),cytokeretin19 fragment(CYFRA21-1), neuron-specific enolase(NSE)] measurement for diagnosis of lung cancer. Methods 350 patients were performed 99mTc-MIBl imaging, multi-slice spiral CT and measurements of tumor markers apart within one week. 200 patients were proved by pathology lung cancer in all 350 patients. Results The sensitivity, specificity and accuracy obtained with the three methods and combination of three methods were 74.5 %(149/200), 68.7 %(103/150), 72.0 %(252/350);97.5 %(195/200), 42.7 %(64/150), 74.0 %(259/350);62.5 %(125/200), 28.7 %(43/150), 48.0 %(168/350) and 99.5 %(199/200), 82.0 %(123/150), 92.0 %(322/350),respectively. Conclusion The results imply that three methods has its distinct important clinical value in diagnosis of lung cancer respectively. The diagnostic efficacy of the combination of three methods is superior to any single one at present situation.