CT影像学特征与肿瘤特异性标志物联合诊断肺癌的价值
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摘要
目的:探讨CT影像学特征与肿瘤特异性标志物联合诊断肺癌的价值。方法:选取我院于2016年3月至2017年9月收治的老年肺癌患者97例作为观察组;选取我院于2016年3月至2017年9月健康体检者68例作为对照组。老年肺癌患者均采用SIEMENS双源CT(Definition Flash)胸部扫描。取患者血清标本,采用电化学发光法测定血清特异性标志物水平变化,包括癌胚抗原(CEA)、神经元特异烯醇化酶(NSE)、癌抗原19-9(CA19-9)、细胞角蛋白21-1(CYFRA21-1)。结果:观察组血清CEA、NSE、CA19-9和CYFRA21-1含量高于对照组,且有统计学差异(P<0.05);周围型肺癌组和中央型肺癌组血清CEA、NSE、CA19-9和CYFRA21-1含量变化无统计学差异(P>0.05);CT扫描与血清肿瘤特异性标志物联合诊断灵敏度和特异度高于CT扫描及血清肿瘤特异性标志物。结论:CT影像学特征与肿瘤特异性标志物联合诊断肺癌的灵敏度和特异度高,值得临床研究。
Objective: To investigate the combined diagnostic value of CT imaging features and tumor specific markers in lung cancer. Methods: 97 elderly patients with lung cancer treated in our hospital from March 2016 to September 2017 were selected as the observation group,and 68 healthy people from March 2016 to September 2017 in our hospital were selected as the control group. SIEMENS CT( Definition Flash) was performed in elderly patients with lung cancer. The serum samples of patients,measuring the changes of serum specific markers by ELISA,including carcinoembryonic antigen( CEA),phosphoenolpyruvate converting enzyme( NSE),cancer antigen 19-9( CA19-9),cytokeratin 21-1( CYFRA21-1). Results: The serum levels of CEA,NSE,CA19-9 and CYFRA21-1 were higher than the control group( P < 0. 05). There was no significant difference in peripheral lung cancer group and the central lung cancer group serum CEA,NSE,CA19-9 and CYFRA21-1 content( P > 0. 05). CT scan and serum tumor specific markers with higher diagnostic sensitivity and specificity of CT scan and serum tumor specific markers.Conclusion: The combined diagnostic sensitivity and specificity of CT imaging features and specific markers in lung cancer are high,which is worthy of clinical study.
Objective: To investigate the combined diagnostic value of CT imaging features and tumor specific markers in lung cancer. Methods: 97 elderly patients with lung cancer treated in our hospital from March 2016 to September 2017 were selected as the observation group,and 68 healthy people from March 2016 to September 2017 in our hospital were selected as the control group. SIEMENS CT( Definition Flash) was performed in elderly patients with lung cancer. The serum samples of patients,measuring the changes of serum specific markers by ELISA,including carcinoembryonic antigen( CEA),phosphoenolpyruvate converting enzyme( NSE),cancer antigen 19-9( CA19-9),cytokeratin 21-1( CYFRA21-1). Results: The serum levels of CEA,NSE,CA19-9 and CYFRA21-1 were higher than the control group( P < 0. 05). There was no significant difference in peripheral lung cancer group and the central lung cancer group serum CEA,NSE,CA19-9 and CYFRA21-1 content( P > 0. 05). CT scan and serum tumor specific markers with higher diagnostic sensitivity and specificity of CT scan and serum tumor specific markers.Conclusion: The combined diagnostic sensitivity and specificity of CT imaging features and specific markers in lung cancer are high,which is worthy of clinical study.
引文
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[12]Zhang Dingfu,Wu Qiufang,Ge Changzheng.Prognostic value of tumor marker CA19-9 and CA242 in pancreatic cancer metastasis and prognosis[J].Modern Oncology,2017,25(8):1258-1260.[张定富,吴秋芳,戈长征.肿瘤标记物CA19-9、CA242对胰腺癌转移和预后预测价值的分析[J].现代肿瘤医学,2017,25(8):1258-1260.]
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[14]Pan QR,Xu QY.The clinical value of tumor markers SCCA,TPS,NSE and CYFERA21-1 in lung cancer[J].International Journal of Laboratory Medicine,2015,5(24):3543-3544.[潘秋荣,徐勤燕.肿瘤标志物SCCA、TPS、NSE和CYFERA21-1检测在肺癌中的临床价值[J].国际检验医学杂志,2015,5(24):3543-3544.]
[15]Xie BQ,Zhang ZY,Wang Y,et al.The evaluation value of serum CEA,CYFRA21-1,and SCCA for the prognosis of lung cancer patients[J].Shandong Medicine,2017,57(5):54-56.[解宝泉,张志艳,王袁,等.血清CEA、CYFRA21-1及SCCA检测对肺癌患者预后的评估价值[J].山东医药,2017,57(5):54-56.]
[16]Du JH,Qiao HY,Yin YF.The effect of serum CEA,CA125 and Cyfra21-1 on the prognosis of patients with advanced non-small cell lung cancer[J].Tumor Prevention and Control,2016,43(2):137-140.[杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.]
[2]Wang Q,Wang Q,Wang SF,et al.Oral Chinese herbal medicine as maintenance treatment after chemotherapy for advanced non-small-cell lung cancer:a systematic review and meta-analysis[J].Current Oncology,2017,24(4):269.
[3]Rizzo S,Petrella F,Buscarino V,et al.CT radiogenomic characterization of EGFR,K-RAS,and ALK mutations in non-small cell lung cancer[J].European Radiology,2016,26(1):32-42.
[4]Li YP,Yin J.Clinical analysis of serum tumor markers and high risk factors for lung cancer[J].Chinese Journal of Lung Disease:Electronic Version,2017,10(3):321-324.[李艳萍,殷俊.血清肿瘤标志物与肺癌高危因素的临床分析[J].中华肺部疾病杂志:电子版,2017,10(3):321-324.]
[5]Lovinfosse P,Janvary ZL,Coucke P,et al.FDG PET/CT texture analysis for predicting the outcome of lung cancer treated by stereotactic body radiation therapy[J].European Journal of Nuclear Medicine&Molecular Imaging,2016,43(8):1-8.
[6]Jr PE,Greco E,Gatsonis C,et al.Lung cancer incidence and mortality in national lung screening trial participants who underwent low-dose CT prevalence screening:a retrospective cohort analysis of a randomised,multicentre,diagnostic screening trial[J].Lancet Oncology,2016,17(5):590.
[7]Nu EL,Yu YY,Han WG,et al.The relationship between CT signs of central lung squamous cell carcinoma and small cell lung cancer and the value of serum tumor markers and the value of combined diagnosis[J].China CT and MRI Journal,2015,14(9):57-61.[努尔兰,余莹莹,韩文广,等.中央型肺鳞癌、小细胞肺癌CT征象与血清肿瘤标志物的关系及联合诊断的价值[J].中国CT和MRI杂志,2015,14(9):57-61.]
[8]Yang Han,Luo Suxia.The value of six tumor markers in the diagnosis of lung cancer and its clinical application[J].Modern Oncology,2016,24(4):577-581.[杨含,罗素霞.六种肿瘤标志物在肺癌诊断中的价值及其临床应用[J].现代肿瘤医学,2016,24(4):577-581.]
[9]Pei F,Song LB,Song Y,et al.The value of serum CYFRA21-1,NSE and CEA in the diagnosis of non-small cell lung cancer[J].Journal of Hainan Medical University,2015,21(4):530-533.[裴峰,宋立彪,宋瑛,等.血清CYFRA21-1、NSE和CEA对非小细胞肺癌辅助诊断的价值分析[J].海南医学院学报,2015,21(4):530-533.]
[10]Zhou JT,Xu JJ,Huo JF,et al.The clinical significance of perioperative monitoring of serum CEA,CA19-9,CA125 and CA153 in patients with lung cancer[J].Modern Biomedical Progress,2016,16(15):2896-2898.[周婧婷,许晶晶,霍剑锋,等.肺癌患者血清CEA,CA19-9,CA125及CA153围手术期动态监测的临床意义[J].现代生物医学进展,2016,16(15):2896-2898.]
[11]Liang HB,Chen YH,Liu JH.The value of serum CEA,CA19-9,SCC-Ag in lung cancer screening[J].Journal of Taishan Medical University,2017,38(6):669-670.[梁惠碧,陈映慧,刘建辉.血清CEA、CA19-9、SCC-Ag在肺癌筛查的价值[J].泰山医学院学报,2017,38(6):669-670.]
[12]Zhang Dingfu,Wu Qiufang,Ge Changzheng.Prognostic value of tumor marker CA19-9 and CA242 in pancreatic cancer metastasis and prognosis[J].Modern Oncology,2017,25(8):1258-1260.[张定富,吴秋芳,戈长征.肿瘤标记物CA19-9、CA242对胰腺癌转移和预后预测价值的分析[J].现代肿瘤医学,2017,25(8):1258-1260.]
[13]Liu LH,Luo JX,Xu YJ,et al.Comparison of serum tumor markers CYFRA21-1,NSE and CEA in different pathological types of lung cancer[J].Journal of Wuhan University(Medical Science),2015,36(4):533-535.[刘连红,罗建祥,徐月君,等.不同病理类型肺癌患者血清肿瘤标志物CYFRA21-1、NSE和CEA水平的比较[J].武汉大学学报(医学版),2015,36(4):533-535.]
[14]Pan QR,Xu QY.The clinical value of tumor markers SCCA,TPS,NSE and CYFERA21-1 in lung cancer[J].International Journal of Laboratory Medicine,2015,5(24):3543-3544.[潘秋荣,徐勤燕.肿瘤标志物SCCA、TPS、NSE和CYFERA21-1检测在肺癌中的临床价值[J].国际检验医学杂志,2015,5(24):3543-3544.]
[15]Xie BQ,Zhang ZY,Wang Y,et al.The evaluation value of serum CEA,CYFRA21-1,and SCCA for the prognosis of lung cancer patients[J].Shandong Medicine,2017,57(5):54-56.[解宝泉,张志艳,王袁,等.血清CEA、CYFRA21-1及SCCA检测对肺癌患者预后的评估价值[J].山东医药,2017,57(5):54-56.]
[16]Du JH,Qiao HY,Yin YF.The effect of serum CEA,CA125 and Cyfra21-1 on the prognosis of patients with advanced non-small cell lung cancer[J].Tumor Prevention and Control,2016,43(2):137-140.[杜军华,乔洪源,尹宜发.血清CEA、CA125及Cyfra21-1水平对中晚期非小细胞肺癌患者预后的影响[J].肿瘤防治研究,2016,43(2):137-140.]