肺孤立性病变CT诊断与肿瘤标志物检测联合诊断的价值

目的探讨肺孤立性病变CT表现与血清3种常用肿瘤标志物检测联合诊断的价值。方法选择160例肺孤立性病变的患者均摄胸部平片及CT扫描,并做肿瘤标志物CEA、NSE、LTA外周血清检测;结果CT诊断恶性病变,确诊为64例,未定性诊断12例,误诊22例;良性病变确诊为43例,未定性诊断6例,误诊13例。3项肿瘤标志物检测水平鳞癌LTA84.6%、腺癌CEA86.2%、小细胞未分化癌NSE85.7%,良性病变3项肿瘤标记物均不敏感。CT扫描与肿瘤标记物联合诊断率提高,在恶性病变中鳞癌15.4%,腺癌17.2%,小细胞未分化癌28.5%,良性病变为11.2%。结论CT扫描与3种常见肿瘤标记物检测联合诊断在肺部孤立性病变的定性诊断,特别是良恶性病变的鉴别及恶性病变的病理分型起着十分重要的作用,为临床诊断与治疗提供更为可靠的依据。

The value of CT scan combined with estimation of serum tumor markers in the diagnosis of pulmonary solitary lesion

Objective To evaluate the combinative diagnostic value of CT representation and estimation of several common serum tumor markers of pulmonary solitary lesion. Methods Plain chest film and CT scanning were performed in 160 cases of pulmonary solitary lesion and peripheral serum CEA, NSE, LTA were estimated. Results Among 160 cases, number of certain diagnosis, uncertain diagnosis and mistaken diagnosis of CT 66,12,22 in malignant lesions respectively; it was 43, 6, 13 in benign lesions respectively. Rate of sensitivity of the three tumor markers to squamous carcinoma, adenocarcinoma, small cell carcinoma was 84.6%, 86.2%, 85.7% respectively; it was not sensitive to the benign lesions. After the combination of CT scanning and the tumour markers, diagnostic rate was elevated(15.4% in squamous carcinoma, 17.2% in adenocarcinoma, 28.5% in small cell carcinoma;11.2% in benign lesions.) Conclusions It plays an important role in the qualitative diagnosis of pulmonary solitary lesions, especially in the differentiation of benign and malignant lesions and pathologic type of malignant lesions after the combination of CT scanning with the estimation of several common tumor markers. It can provide more available evidence to the clinical diagnosis and treatment.