99Tcm-HL91显像、CT和血清肿瘤标志物测定联合应用诊断肺癌

目的探讨Tc^m-4，9-二氮．3，3，10，10-四甲基十二烷-2，11-二酮肟(HL91)显像、CT、血清肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片断(CYFRA21-1)、神经元特异性烯醇酶(NSE)]测定联合应用对肺癌的诊断价值。方法46例疑为肺癌患者在1周内进行^99Tc^m-HL91 SPECT显像、CT检查和血清肿瘤标志物测定。计算每种方法及三法联合应用诊断肺癌的灵敏度、特异性及准确性。结果最终经病理检查或细胞学诊断证实肺癌26例，经病理检查或治疗后影像学随访确诊肺部良性病变20例。^99Tc^m-HL91 SPECT显像、CT及血清肿瘤标志物测定诊断肺癌的灵敏度、特异性及准确性分别为77％、80％、78％，96％、60％、80％及50％、60％、54％。三法联合应用诊断肺癌的灵敏度、特异性及准确性分别为100％、90％、96％，其综合诊断效能明显优于其中任何一种检查方法。结论^99Tc^m-HL91显像、CT、血清肿瘤标志物测定联合应用在肺部肿瘤良恶性鉴别诊断中有较大价值。

Diagnostic value of combination of 99Tcm-HL91 imaging, CT and tumor marker measurements for lung cancer

Objective To explore the clinical value of the combination of three methods including 99 Tc m 4,9 diaza 3,3,10,10 tetramethyldodecan 2,11 dione dioxime (HL91) imaging, CT and tumor markers carcinoembryonic antigen (CEA), cytokeretin 19 fragment (CYFRA21 1), neuron specific enolase (NSE)] measurement for detecting lung tumors. Methods Forty six patients with suspected lung cancer underwent 99 Tc m HL91 SPECT, CT and measurements of tumor markers apart within one week. Results Twenty six patients were found to be with primary malignancy of the lung, whereas twenty cases with benign diseases. The sensitivity, specificity and accuracy obtained with 99 Tc m HL91 SPECT, CT, tumor marker measurements and the combination of the three methods were 77%, 80%, 78%; 96%, 60%, 80%; 50%, 60%, 54%and 100%, 90%, 96%, respectively. The diagnostic efficacy of the combination of the three methods was superior to any single one of the three methods. Conclusion The result implies that the combination of the three methods is the best choice for differentiating benign and malignant pulmonary lesions at present situation.