论文部分内容阅读
目的探讨螺旋CT、能谱CT与PET-CT扫描诊断肺癌的临床价值。方法选取61例疑似肺癌患者,采用螺旋CT、能谱CT及PET-CT扫描,同时行血清癌胚抗原(CEA)、非小细胞肺癌相关抗原细胞角蛋白19片段抗原21-1(CYFRA21-1)及神经元烯醇化酶(NSE)检测,比较不同扫描方法及不同扫描方法联合肿瘤标志物的诊断价值。结果61例患者经3种扫描方法检查,PET-CT诊断的真阳性患者43例(70.49%),能谱CT为40例(59.02%),螺旋CT为35例(59.02%),3种诊断方法的差异有统计学意义(P<0.05);16例肺腺癌患者通过能谱CT诊断14例,PET-CT和螺旋CT分别诊断13例和12例,PET-CT与能谱CT诊断的灵敏度分别为93.48%和86.96%,均高于螺旋CT(76.09%,P<0.05),PET-CT与能谱CT扫描的准确率分别为91.80%和81.97,均优于螺旋CT(68.85%,P<0.05)。PET-CT与能谱CT对纵膈转移性淋巴结检出率分别为88.89%和77.78%,显著高于螺旋CT(61.11%,P<0.05)。将3种扫描方法与肿瘤标志物检测联合诊断肺癌,PET-CT、能谱CT联合肿瘤标志物诊断的特异度分别为86.67%和78.57%,均高于螺旋CT(66.67%,P<0.05);PET-CT及能谱CT联合肿瘤标志物检测诊断的准确率分别为93.44%和88.52%,均高于螺旋CT(78.69%,P<0.05);能谱CT扫描联合肿瘤标志物检测与PET-CT诊断的灵敏度(91.49%,93.48%)和准确率(88.52%,91.80%),均无明显差异(P<0.05)。结论螺旋CT、能谱CT和PET-CT在诊断肺癌方面,PET-CT的灵敏度和准确率最高,能谱CT次之,螺旋CT最低。在诊断纵膈转移性淋巴结方面也有明显差异(P<0.05)。能谱CT诊断肺腺癌具有一定的优势,而能谱CT扫描联合肿瘤标志物检测与PET-CT诊断肺腺癌具有相似的临床效果。
Objective To investigate the clinical value of spiral CT, spectral CT and PET-CT in the diagnosis of lung cancer. Methods Sixty-one patients with suspected lung cancer were enrolled in this study. Serum CEA, CTL-19 antigen 21-1 (CYFRA21-1 ) And neuron enolase (NSE), and to compare the diagnostic value of different scanning methods and different scanning methods in combination with tumor markers. Results Totally 61 patients were examined by three kinds of scanning methods. 43 cases (70.49%) were diagnosed by PET-CT, 40 cases (59.02%) were CT scans, 35 cases (59.02%) were CT scans, (P <0.05). There were 14 cases diagnosed by radiofrequency CT in 16 cases of lung adenocarcinoma, 13 cases were diagnosed by PET-CT and spiral CT, 12 cases were diagnosed by PET-CT and CT The sensitivity was 93.48% and 86.96% respectively, which was higher than that of spiral CT (76.09%, P <0.05). The accuracy of PET-CT and energy spectrum CT was 91.80% and 81.97, P <0.05). The detection rates of PET-CT and SPECT on mediastinal lymph nodes were 88.89% and 77.78%, respectively, which were significantly higher than that of spiral CT (61.11%, P <0.05). The specificity of CT-CT combined with tumor markers detection in diagnosing lung cancer, PET-CT and SPECT was 86.67% and 78.57%, respectively, which were higher than that of spiral CT (66.67%, P <0.05) ; PET-CT and energy spectrum CT combined detection of tumor markers were 93.44% and 88.52% respectively, which were higher than that of spiral CT (78.69%, P <0.05) There was no significant difference (P <0.05) in the sensitivity of CT diagnosis (91.49%, 93.48%) and accuracy (88.52%, 91.80%). Conclusion CT-CT and PET-CT have the highest sensitivity and accuracy in the diagnosis of lung cancer, followed by energy spectrum CT and the lowest spiral CT. In the diagnosis of mediastinal lymph node metastasis also had significant differences (P <0.05). Spectrum CT diagnosis of lung adenocarcinoma has certain advantages, and the combination of spectrum CT scan with tumor marker detection and PET-CT diagnosis of lung adenocarcinoma has similar clinical effect.