在肺癌诊断中血清肿瘤抗原检测结合CT-扫描与PET／CT的比较

目的：比较肿瘤标志物联合螺旋CT扫描与PET／CT全身代谢显像对肺癌诊断及分期准确率的区别。方法：选择手术或穿刺活检确诊为肺癌，且术前行螺旋CT扫描并有血清学肿瘤抗原检测或PET／CT扫描的患者。比较两种方法对肺癌的检出率以及对肺癌分期的影响。结果：肿瘤抗原检测联合CT扫描与PET／CT显像对肺癌诊断相符率分别为67．44％和90．70％，肺癌局部病灶显示阳性率分别为86．05％和95．35％，对纵隔淋巴结检出的阳性率分别为65．12％利83．72％．同时PETCT显像检出肿瘤标志物联合CT扫描未发现的6例远处转移；与CT扫描相比。PETCT显像使43例患者的临床分期提前11．63％，推后16．28％，使9．3％（4例）的患者改变了治疗方式。结论：PETCT全身代谢显像比血清学检查肿瘤抗原联合CT扫描对肺癌的诊断阳性率更高，且对肺癌的分期更加准确。PETCT全身代谢显像是诊断肺癌及进一步明确肺癌分期的一种良好方法。

COMPARATION OF THE ACCURACY OF TUMOR ANTIGEN ASSOCIATED WITH COMPUTER TOMORGAPHY SCAN I,~3R LUNG CANCER DIAGNOSIS AND STAGING

Objective:To compare the accuracy of tumor antigen associated with computer tomography scan for lung can- cer diagnosis and staging.Method:Selecting lung cancer patients diagnosed by operation or acupuncture,with breast CT scan and/ or tumor antigen detection,or with PET/CT detection,to compare the accuracy or affection on staging in lung cancer.Results: The accuracy rate for lung caner diagnosis of tumor antigen detection associated with CT ccan and PET/CT detection was 67.44 % and 90/70 % respectively.Local focus detection rate was 86.05 % and 95.35 % respectively,and mediastinal lymph nodes detection rate was 65.12% and 83.72% respectively.And 6 cases beyond metastasis were detected by PET/CT.Compared with CT scan, tumor stage was upstaged in 11.63% and downstaged in 16.28% by PET/CT,and led to a change of the therapeutic strategy in 9.3 %(4 cases)of patients.Conclusion:Compared with tumor antigen detection associated with CT scan,PET/CT detection was more sensitive in diagnosis or staging for lung cancer.So it is a good method for lung cancer diagnosis.