论文部分内容阅读
目的评价18氟脱氧葡萄糖(18F-FDG)符合线路断层显像结合血清肿瘤标志物测定对肺部肿块良恶性鉴别的应用价值,并对两种方法进行比较。方法对104例胸部X线或CT怀疑肺癌的患者行18F-FDG符合线路显像及癌胚抗原(CEA)、细胞角蛋白片段(CYFRA21-1)和神经元特异性烯醇化酶(NSE)检测,两种检查在1周内全部完成。对肺部病变的18F-FDG浓聚程度及特征进行分析,以局部斑块状放射性异常浓聚灶为阳性(肺癌);无明显放射性浓聚或浓聚呈云片状、散在性模糊的影像为阴性(良性)。三项肿瘤标志物中有1项或1项以上超过正常值上限即为阳性(肺癌)。上述检查完成后1个月内得到病理等最终诊断结果。结果66例患者确诊为肺癌,38例为肺部良性病变。18F-FDG符合线路显像对肺癌诊断的灵敏度、特异性和准确性分别为80．0％、77．2％和77．9％;血清肿瘤标志物对肺癌诊断的灵敏度、特异性和准确性分别为56．0％、60．9％和64．4％。统计结果显示,18F-FDG符合线路显像对肺癌诊断的灵敏度、特异性和准确性均明显优于血清肿瘤标志物测定。在5例18F-FDG符合线路显像检查假阴性的肺癌患者中,有4例血清肿瘤标志物测定为阳性,提示后者对肺癌的诊断仍有一定的参考价值。结论18F-FDG符合线路显像结合血清肿瘤标志物测定有助于提高肺癌诊断的阳性率。
Objective To evaluate the value of 18F-FDG coincidence tomography combined with serum tumor markers in the differential diagnosis of lung masses and to compare the two methods. Methods Totally 104 patients with chest X-ray or CT suspected lung cancer underwent 18F-FDG coincidence imaging and CEA, CYFRA21-1 and NSE detection Both tests completed within 1 week. The concentration and characteristics of 18F-FDG in lung lesions were analyzed, and the focal patchy radioactive lesions were positive (lung cancer). There was no obvious radioactive aggregation or aggregation of cloud-like and scattered fuzzy images Negative (benign). One or more of the three tumor markers exceed the upper limit of normal and are positive (lung cancer). Within 1 month after the completion of the above examination, the final diagnosis result of the pathology is obtained. Results 66 patients were diagnosed as lung cancer, 38 patients with benign lung disease. The sensitivity, specificity and accuracy of 18F-FDG coincidence imaging in the diagnosis of lung cancer were 80.0%, 77.2% and 77.9% respectively. The sensitivity, specificity and accuracy of serum tumor markers in the diagnosis of lung cancer Respectively 56.0%, 60.9% and 64.4%. The statistical results showed that the sensitivity, specificity and accuracy of 18F-FDG coincidence line imaging in diagnosing lung cancer were significantly better than those of serum tumor markers. In 5 cases of 18F-FDG coincidence line imaging examination of false negative lung cancer patients, 4 cases of serum tumor markers were determined as positive, suggesting that the latter for the diagnosis of lung cancer is still some reference value. Conclusion 18F-FDG coincidence imaging with serum tumor markers can be helpful to improve the diagnostic accuracy of lung cancer.