摘要
目的 探讨胸部CT联合血清糖类抗原242(CA242)、细胞角蛋白19片段(CYFRA21-1)对良恶性肺结节的诊断价值。方法 回顾性选取2023年1月—2024年12月联勤保障部队第九二〇医院呼吸与危重症医学科收治的恶性肺结节(肺癌)患者98例为肺癌组,另选取同期收治的良性肺结节患者76例为良性结节组。采用酶联免疫吸附实验(ELISA)检测血清CA242、CYFRA21-1水平;采用Kappa检验分析胸部CT单独及联合血清CA242、CYFRA21-1诊断肺结节良恶性与病理诊断的一致性;受试者工作特征(ROC)曲线分析胸部CT及血清CA242、CYFRA21-1对肺结节良恶性的诊断价值。结果 肺癌组血清CA242、CYFRA21-1水平高于良性结节组(t/P=8.194/<0.001、8.326/<0.001);肺癌组结节直径及毛刺征、空泡征、胸膜凹陷征比例高于良性结节组(t/χ^(2)/P=17.422/<0.001、14.456/<0.001、19.531/<0.001、18.316/<0.001);胸部CT单独及联合血清CA242、CYFRA21-1诊断肺结节良恶性的Kappa值分别为0.738、0.884,与病理诊断的一致性分别为较高、极高(P<0.01);ROC曲线分析显示,胸部CT、血清CA242、CYFRA21-1单独及三者联合诊断肺结节良恶性的曲线下面积(AUC)分别为0.863、0.837、0.842、0.943,其中三者联合诊断AUC高于各自单独诊断的AUC(Z/P=2.169/0.030、2.873/0.004、2.801/0.005)。结论 胸部CT联合血清CA242、CYFRA21-1可显著提高肺结节良恶性的诊断准确度,有利于肺癌的早期筛查。
Objective To explore the diagnostic value of chest CT combined with serum carbohydrate antigen 242(CA242)and cytokeratin 19 fragment(CYFRA21-1)for benign and malignant pulmonary nodules.Methods From January 2023 to December 2024,98 patients with malignant pulmonary nodules(lung cancer)admitted to the Department of Respirato-ry and Critical Care Medicine of the 920th Hospital of the Joint Logistics Support Force were retrospectively selected as the lung cancer group,while 76 patients with benign pulmonary nodules admitted during the same period were selected as the be-nign nodule group.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum CA242 and CYFRA21-1 levels.Kappa analysis was used to evaluate the consistency between chest CT alone and in combination with serum CA242 and CY-FRA21-1 for diagnosing benign and malignant pulmonary nodules compared with pathological diagnosis.Receiver operating characteristic curve(ROC)analysis was used to assess the diagnostic value of chest CT and serum CA242 and CYFRA21-1 for benign and malignant pulmonary nodules.Results Serum levels of CA242 and CYFRA21-1 in the lung cancer group were higher than those in the benign nodule group(t/P=8.194/<0.001,8.326/<0.001).The proportion of patients with larger nodule diameter,spiculation sign,vacuolar sign,and pleural indentation sign in the lung cancer group was higher than that in the benign nodule group(t/χ^(2)/P=17.422/<0.001,14.456/<0.001,19.531/<0.001,18.316/<0.001).The Kappa values for chest CT alone and in combination with serum CA242 and CYFRA21-1 for diagnosing benign and malignant pulmonary nodules were 0.738 and 0.884,respectively,indicating high and excellent consistency with pathological diagnosis(P<0.01).The area under the curve(AUC)for chest CT,serum CA242,CYFRA21-1 alone,and their combination in diagnosing benign and ma-lignant pulmonary nodules were 0.863,0.837,0.842,and 0.943,respectively.The AUC of the combined diagnosis of all three was higher than that of each individual method(Z/P=2.169/0.030,2.873/0.004,2.801/0.005).Conclusion Chest CT combined with serum CA242 and CYFRA21-1 can significantly improve the diagnostic accuracy for benign and malignant pulmonary nodules,which is beneficial for early screening of lung cancer.
作者
魏蛟
张鑫
华正锋
代金娥
杨银花
刘奕君
成友华
Wei Jiao;Zhang Xin;Hua Zhengfeng;Dai Jin'e;Yang Yinhua;Liu Yijun;Cheng Youhua(Department of Radiological Diagnosis,the 920th Hospital of the Joint Logistics Support Force,Yunnan,Kunming 650032,China;不详)
出处
《疑难病杂志》
2025年第11期1297-1301,共5页
Chinese Journal of Difficult and Complicated Cases
基金
云南省科技厅科技计划项目(202201AZ070001-108)。
关键词
肺癌
肺结节
胸部CT
糖类抗原242
细胞角蛋白19片段
诊断
Lung cancer
Benign nodules
Chest CT scan
Carbohydrate antigen 242
Cytokeratin 19 fragment
Diag-nosis
