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

发布时间：2018-06-15 21:09

本文选题：肿瘤标志物 + 肺癌概率模型　；参考：《中国呼吸与危重监护杂志》2017年04期

【摘要】：目的探讨肿瘤标志物、肺癌概率模型在肺部结节鉴别诊断中的价值。方法纳入2013年1月至2016年1月诊治的117例肺部结节患者,根据病理结果分为肺癌组(76例)和良性病变组(41例)。分析肿瘤标志物、肺癌概率模型在肺部结节鉴别诊断中的价值。结果肺癌组癌胚抗原、糖类抗原125、神经元特异性烯醇化酶、细胞角蛋白19片段抗原21-1和肺癌概率阳性率高于良性病变组(P0.05)。肿瘤标志物联合检测肺癌的敏感性、特异性、准确性分别为72.37%、73.17%、72.65%。应用肺癌概率模型计算每例肺部结节的肺癌概率,受试者工作特征(ROC)曲线下面积为0.7430.7。选取肺癌概率的截断点为28.5%,敏感性、特异性、准确性分别为63.16%、78.05%、68.68%。两种方法联合检测肺癌的敏感性、特异性和准确性分别为93.42%、68.29%、92.31%,与单纯使用肿瘤标志物或肺癌概率模型相比,敏感性和准确性都显著提高(P0.01)。结论肿瘤标志物联合肺癌概率模型可显著提高肺部结节诊断的敏感性和准确性,为肺部结节的鉴别诊断提供重要临床参考价值。
[Abstract]:Objective to explore the value of tumor markers and lung cancer probability model in differential diagnosis of pulmonary nodules. Methods from January 2013 to January 2016, 117 patients with pulmonary nodules were divided into lung cancer group (n = 76) and benign lesion group (n = 41). The value of tumor markers and lung cancer probability model in differential diagnosis of pulmonary nodules was analyzed. Results the positive rates of carcinoembryonic antigen, carbohydrate antigen 125, neuron-specific enolase, cytokeratin 19 fragment antigen 21-1 and lung cancer probability in lung cancer group were higher than those in benign lesion group (P 0.05). The sensitivity, specificity and accuracy of combined detection of tumor markers were 72.37 and 73.17 respectively. The lung cancer probability model was used to calculate the lung cancer probability of each lung nodule. The area under the operating characteristic ROC curve was 0.7430.7. The cut-off point of the probability of lung cancer was 28.5.The sensitivity, specificity and accuracy were 63.160.78.05 and 68.68, respectively. The sensitivity, specificity and accuracy of the two methods for the detection of lung cancer were 93.42, 68.29 and 92.31, respectively. The sensitivity and accuracy of the two methods were significantly higher than those of using tumor markers or lung cancer probability models alone. Conclusion tumor markers combined with the probability model of lung cancer can significantly improve the sensitivity and accuracy of pulmonary nodules, and provide important clinical reference value for the differential diagnosis of pulmonary nodules.
【作者单位】：郑州大学第一附属医院呼吸与危重症医学科;武汉大学中南医院输血科;
【基金】：河南省科技攻关计划项目(154200510015)
【分类号】：R734.2

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