肺肿瘤标记物检测联合MSCT检查对孤立性肺结节诊断价值
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摘要
目的旨在探讨肺血清肿瘤标记物检测联合MSCT检查对孤立性肺结节诊断价值。方法选取我院2015年1月至2016年12月收治的孤立性肺结节患者142例,收集142例肺部结节患者的临床资料、影像学资料等,以纤维支气管镜活检结果为金标准,比较肿瘤标记物检测、MSCT及两者联合检测的对孤立性肺结节的诊断效能。结果 MSCT诊断良、恶性孤立性肺结节符合率分别为76.31%、69.69%,总体诊断符合率为73.23%(104/142);血清肿瘤标志物联合诊断良、恶性孤立性肺结节符合率分别为84.21%、56.06%,总体诊断符合率为71.12%(101/142);血清肿瘤标志物联合MSCT诊断良、恶性孤立性肺结节特异度、灵敏度分别为92.25%、84.50%,明显优于血清肿瘤标志物联合检测、MSCT检查,差异具有统计学意义(P<0.05)。结论肺肿瘤标记物检测联合MSCT检查可提高对孤立性肺结节诊断的特异度、灵敏度。
Objective to explore diagnostic value of lung serum tumor markers combined with MSCT detection for solitary pulmonary nodules. Methods choose 142 cases solitary pulmonary nodules patients treated in our hospital from January 2015 to December 2016, collect their clinical data and imaging findings, compare diagnostic effect for solitary pulmonary nodules of tumor markers detection, MSCT and combination with gold standard of fiberoptic bronchoscopy biopsy results. Results benign and malignant coincidence rate of solitary pulmonary nodules by of MSCT diagnosis was 76.31%, 69.69%, overall diagnostic coincidence rate was 73.23%(104/142); benign and malignant coincidence rate of solitary pulmonary nodules was 84.21%, 56.06% by serum tumor markers combination diagnosis, overall diagnostic rate was 71.12%(101/142); specificity and sensitivity degree of benign and malignant solitary pulmonary nodules by serum tumor markers combined MSCT diagnosis was 92.25% and 84.50%, significantly better than serum tumor markers combined with MSCT detection, difference showed statistical significance,(P< 0.05). Conclusion lung tumor markers combined with MSCT detection can improve specificity and sensitivity of solitary pulmonary nodules diagnosis.
Objective to explore diagnostic value of lung serum tumor markers combined with MSCT detection for solitary pulmonary nodules. Methods choose 142 cases solitary pulmonary nodules patients treated in our hospital from January 2015 to December 2016, collect their clinical data and imaging findings, compare diagnostic effect for solitary pulmonary nodules of tumor markers detection, MSCT and combination with gold standard of fiberoptic bronchoscopy biopsy results. Results benign and malignant coincidence rate of solitary pulmonary nodules by of MSCT diagnosis was 76.31%, 69.69%, overall diagnostic coincidence rate was 73.23%(104/142); benign and malignant coincidence rate of solitary pulmonary nodules was 84.21%, 56.06% by serum tumor markers combination diagnosis, overall diagnostic rate was 71.12%(101/142); specificity and sensitivity degree of benign and malignant solitary pulmonary nodules by serum tumor markers combined MSCT diagnosis was 92.25% and 84.50%, significantly better than serum tumor markers combined with MSCT detection, difference showed statistical significance,(P< 0.05). Conclusion lung tumor markers combined with MSCT detection can improve specificity and sensitivity of solitary pulmonary nodules diagnosis.
引文
[1]黄微,余荣,于会明,等.64排螺旋CT对肺癌合并肺内结节的2年随访研究[J].中国医药导报,2016,13(13):105-108.
[2]努尔兰·吐尔逊,周永,韩文广,等.MSCT联合肿瘤标志物检查对中央型小细胞肺癌及非小细胞肺癌的鉴别诊断价值[J].临床放射学杂志,2016,35(5):711-716.
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[4]赵义刚,宋波.锝99-甲氧基乙腈亲肿瘤显像联合血清肿瘤标志物诊断肺结节良恶性的临床价值[J].标记免疫分析与临床,2016,23(7):741-743.
[5]刘晓飞,李鹏程,何宝明,等.-(18)F-FDG PET/CT显像联合血清肿瘤标志物组合在孤立性肺结节诊断中的价值[J].现代肿瘤医学,2017,25(8):1230-1234.
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[7]冯刚,寇介丽,蒋浩,等.多层螺旋CT灌注成像对外周型小结节状肺腺癌淋巴结转移的诊断价值[J].中国肿瘤临床与康复,2017,23(4):440-442.
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[9]张实,张明周,吴学玲.支气管肺泡灌洗液4种新型肿瘤标志物检测对周围型肺癌的诊断价值[J].解放军医学杂志,2015,40(3):206-211.
[10]王一北,陈宽冰,张洪岩,等.血清肿瘤标记物对肺部结节的诊断价值[J].临床肺科杂志,2017,22(4):598-601.
[11]王琳,吴传勇,娄加陶.肿瘤标记物检测在肺部孤立性结节鉴别诊断中的价值[J].现代免疫学,2016,36(5):405-409.
[12]刘卫金,张冬,杨春艳,等.肺部孤立性结节或肿块MSCT灌注成像与微血管密度的相关性研究[J].第三军医大学学报,2008,30(19):1845-1848.
[13]Rezaie A A,Habiboghli A.Detection of Lung Nodules on Medical Images by the Use of Fractal Segmentation[J].International Journal of Interactive Multimedia&Artificial Intelligence,2017,4(5):15-19.
[14]杜润军.CT联合肿瘤标记物检测判定孤立性肺结节良恶性的价值[J].贵阳医学院学报,2014,39(3):399-401.
[15]韦逸婷,刘国瑞.胃泌素释放肽前体检测方法的发展及应用[J].临床检验杂志,2016,34(10):782-784.
[16]吴培生,徐爱晖.胃泌素释放肽前体在小细胞肺癌中的表达水平及其意义[J].中国全科医学,2014,16(32):3885-3887.
[17]李生虎,徐香玖,黄刚.MSCT征象与肿瘤因子的关系及联合检测对肺癌诊断价值的研究[J].临床放射学杂志,2012,31(1):42-45.
[18]Catharina,M.KORSE,Stefan,等.一项在欧洲和中国进行的新型胃泌素释放肽前体(Pro GRP)免疫检测多中心评估研究[J].中国肺癌杂志,2017,19(8):568-577.
[19]Tsukamoto Y,Futani H,Kumanishi S,et al.A rare case of Ewing sarcoma with elevated plasma pro-gastrinreleasing peptide(pro GRP)level[J].Human Pathology Case Reports,2016,6(1):13-18.
[20]Mcnittgray M F.Pattern classification approach to characterizing solitary pulmonary nodules imaged on high-resolution computed tomography[J].Proceedings of SPIE-The International Society for Optical Engineeri ng,2016,27(1):1024-1034.
[2]努尔兰·吐尔逊,周永,韩文广,等.MSCT联合肿瘤标志物检查对中央型小细胞肺癌及非小细胞肺癌的鉴别诊断价值[J].临床放射学杂志,2016,35(5):711-716.
[3]雷晴,彭波,龙飞,等.孤立性肺结节与肿瘤标记物动态水平的相关性研究[J].四川医学,2016,37(6):588-590.
[4]赵义刚,宋波.锝99-甲氧基乙腈亲肿瘤显像联合血清肿瘤标志物诊断肺结节良恶性的临床价值[J].标记免疫分析与临床,2016,23(7):741-743.
[5]刘晓飞,李鹏程,何宝明,等.-(18)F-FDG PET/CT显像联合血清肿瘤标志物组合在孤立性肺结节诊断中的价值[J].现代肿瘤医学,2017,25(8):1230-1234.
[6]贾国华,周水梅,王静.肿瘤标志物联合肺癌概率模型在肺部结节鉴别诊断中的价值[J].中国呼吸与危重监护杂志,2017,15(4):337-340.
[7]冯刚,寇介丽,蒋浩,等.多层螺旋CT灌注成像对外周型小结节状肺腺癌淋巴结转移的诊断价值[J].中国肿瘤临床与康复,2017,23(4):440-442.
[8]滕雅琴,杨利霞,王季勇,等.计算机辅助检测系统提高CT肺结节检出方式的研究[J].中国医学计算机成像杂志,2016,22(2):116-120.
[9]张实,张明周,吴学玲.支气管肺泡灌洗液4种新型肿瘤标志物检测对周围型肺癌的诊断价值[J].解放军医学杂志,2015,40(3):206-211.
[10]王一北,陈宽冰,张洪岩,等.血清肿瘤标记物对肺部结节的诊断价值[J].临床肺科杂志,2017,22(4):598-601.
[11]王琳,吴传勇,娄加陶.肿瘤标记物检测在肺部孤立性结节鉴别诊断中的价值[J].现代免疫学,2016,36(5):405-409.
[12]刘卫金,张冬,杨春艳,等.肺部孤立性结节或肿块MSCT灌注成像与微血管密度的相关性研究[J].第三军医大学学报,2008,30(19):1845-1848.
[13]Rezaie A A,Habiboghli A.Detection of Lung Nodules on Medical Images by the Use of Fractal Segmentation[J].International Journal of Interactive Multimedia&Artificial Intelligence,2017,4(5):15-19.
[14]杜润军.CT联合肿瘤标记物检测判定孤立性肺结节良恶性的价值[J].贵阳医学院学报,2014,39(3):399-401.
[15]韦逸婷,刘国瑞.胃泌素释放肽前体检测方法的发展及应用[J].临床检验杂志,2016,34(10):782-784.
[16]吴培生,徐爱晖.胃泌素释放肽前体在小细胞肺癌中的表达水平及其意义[J].中国全科医学,2014,16(32):3885-3887.
[17]李生虎,徐香玖,黄刚.MSCT征象与肿瘤因子的关系及联合检测对肺癌诊断价值的研究[J].临床放射学杂志,2012,31(1):42-45.
[18]Catharina,M.KORSE,Stefan,等.一项在欧洲和中国进行的新型胃泌素释放肽前体(Pro GRP)免疫检测多中心评估研究[J].中国肺癌杂志,2017,19(8):568-577.
[19]Tsukamoto Y,Futani H,Kumanishi S,et al.A rare case of Ewing sarcoma with elevated plasma pro-gastrinreleasing peptide(pro GRP)level[J].Human Pathology Case Reports,2016,6(1):13-18.
[20]Mcnittgray M F.Pattern classification approach to characterizing solitary pulmonary nodules imaged on high-resolution computed tomography[J].Proceedings of SPIE-The International Society for Optical Engineeri ng,2016,27(1):1024-1034.