| 张 强,孙云刚,王 朝,邵 丰,庄 宇,姚梦旭,焦思杨.低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物CA12-5、CA19-9在肺癌诊断中的临床应用价值[J].,2022,(21):4066-4070 |
| 低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物CA12-5、CA19-9在肺癌诊断中的临床应用价值 |
| Clinical Application Value of Low Dose Dpiral CT Combined with Lung Cancer Autoantibody and Tumor Markers CA12-5 and CA19-9 in Diagnosis of Lung Cancer |
| 投稿时间：2022-05-17 修订日期：2022-06-12 |
| DOI：10.13241/j.cnki.pmb.2022.21.011 |
| 中文关键词: 肺癌 低剂量螺旋CT 肺癌自身抗体 CA12-5 CA19-9 诊断价值 |
| 英文关键词: Lung cancer Low dose spiral CT Lung cancer autoantibody CA12-5 CA19-9 Diagnostic value |
| 基金项目:江苏省南京市重点课题（ZKX190469）；江苏省卫生计生委医学科研项目（H2017098） |
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| 中文摘要: |
| 摘要 目的：探讨低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物糖类抗原（CA）12-5、CA19-9在肺癌诊断中的临床应用价值。方法：选择2019年1月至2021年12月在我院经低剂量螺旋CT检查发现肺部病灶的患者86例，以病理诊断结果分为肺癌组49例、肺部良性病变组37例，另选取同期健康体检志愿者30例作为对照组。观察肺癌的低剂量螺旋CT影像学特征，检测比较各组血清肺癌自身抗体[p53、SOX区域Y相关HMG蛋白家族成员2（SOX2）、G抗原7（GAGE7）、RNA解旋酶自身抗体4-5（GBU4-5）]及CA12-5、CA19-9水平，并对比阳性表达情况，分析低剂量螺旋CT联合肺癌自身抗体、CA12-5、CA19-9对肺癌的诊断价值。结果：49例肺癌患者经低剂量螺旋CT检查共发现51个病灶，其中实性结节或部分实性结节30个，非实性结节21个；病灶平均直径（10.92±1.17）mm，＜5 mm者9个，5～10 mm者17个，≥10 mm者25个；11个病灶伴有钙化，16个病灶有毛刺征，20个病灶有分叶征；有6例表现为空洞，空洞通常壁薄厚不均匀，呈中心性或偏心性。肺癌组血清p53、SOX2、GAGE7、GBU4-5及CA12-5、CA19-9水平均明显高于肺部良性病变组和对照组，肺部良性病变组上述指标水平均明显高于对照组（P<0.05）。肺癌组CA12-5、CA19-9、4项肺癌自身抗体单独及联合的阳性率均明显高于肺部良性病变组和对照组（P<0.05），肺部良性病变组CA12-5、CA19-9及4项肺癌自身抗体联合的阳性率高于对照组（P<0.05）。低剂量螺旋CT联合4项肺癌自身抗体、CA12-5、CA19-9对肺癌诊断的灵敏度为91.84%，特异度为97.30%，准确度为94.19%。结论：低剂量螺旋CT联合肺癌自身抗体、肿瘤标志物CA12-5、CA19-9在肺癌诊断中有较好的临床应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical application value of low dose spiral CT combined with lung cancer autoantibody and tumor markers carbohydrate antigen (CA)12-5 and CA19-9 in the diagnosis of lung cancer. Methods: A total of 86 patients with lung lesions detected by low dose spiral CT examination in our hospital from January 2019 to December 2021 were selected. According to pathological diagnosis results, they were divided into lung cancer group with 49 cases and benign lung lesions group with 37 cases, another 30 healthy volunteers in the same period were selected as the control group. Low dose spiral CT imaging characteristics of lung cancer were observed, and serum levels of lung cancer autoantibodies [p53, SOX region Y-associated HMG protein family member 2 (SOX2), G antigen 7 (GAGE7), RNA helicase autoantibodies 4-5 (GBU4-5)] and CA12-5 and CA19-9 were detected and compared in each group. The positive expression was compared, the diagnostic value of low dose spiral CT combined with lung cancer autoantibody, CA12-5 and CA19-9 in lung cancer were analyzed. Results: A total of 51 lesions were found in 49 patients with lung cancer by low dose spiral CT, including 30 solid or partially solid nodules, and 21 non-solid nodules. The mean diameter of lesions was (10.92±1.17) mm, 9 lesions were < 5 mm, 17 lesions were 5～10 mm, and 25 lesions were ≥10 mm. 11 lesions had calcification, 16 lesions had burr sign, and 20 lesions had lobulation sign. There were 6 cases of cavity, usually with uneven wall thickness, centrality or eccentricity. The serum levels of p53, SOX2, GAGE7, GBU4-5, CA12-5 and CA19-9 in lung cancer group were significantly higher than those in benign lung lesions group and control group, the levels of above indexes in benign lung lesions group were significantly higher than those in control group (P<0.05). The positive rates of CA12-5, CA19-9 and 4 items lung cancer autoantibodies alone and in combination in lung cancer group were significantly higher than those in benign lung lesions group and control group (P<0.05). The positive rates of CA12-5, CA19-9 and 4 items lung cancer autoantibodies in combination in benign lung lesions group were significantly higher than those in control group (P<0.05). The sensitivity of low dose spiral CT combined with 4 items lung cancer autoantibodies, CA12-5 and CA19-9 in the diagnosis of lung cancer was 91.84%, the specificity was 97.30%, the accuracy was 94.19%. Conclusion: Low dose spiral CT combined with lung cancer autoantibody, tumor markers CA12-5 and CA19-9 has good clinical application value in the diagnosis of lung cancer. |
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