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目的探讨PET/CT、支气管镜及二者联合肿瘤标记物在肺癌中的诊断价值,减少肺癌的误诊率及漏诊率。方法回顾性分析2014年1月-2015年12月就诊于新疆医科大学第一附属医院诊断为肺部占位患者230例经胸膜、淋巴活检及病理确诊为原发性支气管癌患者156例临床资料。比较分析PET/CT影像学特点、支气管镜下表现及肿瘤标记物特点,总结肺癌的临床特征。结果病理诊断为肺癌的156例患者中,由PET/CT诊断为肺癌的有129例,符合病理诊断有102例,准确率为65.4%,灵敏度为68.5%,特异度为66.7%,漏诊率为31.5%;行支气管镜诊断为肺癌有97例,灵敏度为94.2%,特异度为80.2%,准确度为62.2%,漏诊率为5.8%;PET/CT联合支气管镜及肿瘤标记物诊断肺癌有145例,灵敏度为94.8%,准确度为100.0%,漏诊率5.2%。结论PET/CT联合支气管镜及肿瘤标记物诊断肺癌的准确率、灵敏度、特异度均高于单纯运用PET/CT或支气管镜,且漏诊率低于单纯运用PET/CT或支气管镜。
Objective To investigate the diagnostic value of PET / CT, bronchoscope and combined tumor markers in lung cancer and to reduce the misdiagnosis rate and misdiagnosis rate of lung cancer. Methods Retrospective analysis of clinical data of 230 cases diagnosed as primary bronchogenic carcinoma by pleural, lymph biopsy and pathology from January 2014 to December 2015 in the First Affiliated Hospital of Xinjiang Medical University . Comparative analysis of PET / CT imaging features, bronchoscopic features and tumor markers, summary of clinical features of lung cancer. Results Among the 156 patients diagnosed with lung cancer by pathology, there were 129 cases of lung cancer diagnosed by PET / CT, of which 102 cases were pathologically diagnosed. The accuracy was 65.4%, the sensitivity was 68.5% and the specificity was 66.7% 31.5%. Bronchoscopy was diagnosed as lung cancer in 97 cases with sensitivity of 94.2%, specificity of 80.2%, accuracy of 62.2% and misdiagnosis rate of 5.8%. PET / CT combined with bronchoscopy and tumor markers in diagnosis of lung cancer were 145 For example, the sensitivity was 94.8%, the accuracy was 100.0% and the rate of missed diagnosis was 5.2%. Conclusion The accuracy, sensitivity and specificity of PET / CT combined with bronchoscope and tumor marker in the diagnosis of lung cancer are higher than that of PET / CT or bronchoscope alone, and the rate of missed diagnosis is lower than PET / CT or bronchoscope alone.