Value analysis of high-resolution CT three-dimensional reconstruction combined with SHOX2 gene and RASSF1A gene meth-ylation detection in alveolar lavage fluid in diagnosis of early pulmonary nodules
Objective:To explore the value of high-resolution CT three-dimensional reconstruction combined with short stature ho-mologous box gene 2(SHOX2)and Ras related region family A1(RASSF1A)gene methylation detection in bronchoalveolar lavage fluid(BALF)in the diagnosis of early pulmonary nodules.Methods:100 suspected pulmonary nodule patients who visited a hospital from May 2021 to May 2022 and underwent fiberoptic bronchoscopy(FB)were selected.The BALF of the patients was collected under FB,and the methylation status of SHOX2 and RASSF1A genes in the BALF was determined by real-time fluorescence quantitative PCR.At the same time,high-resolution CT three-dimensional reconstruction examination and BALF liquid based thin-layer cell pathol-ogy detection results were collected.Based on pathological results,the patients were divided into a malignant nodule group(n=40)and a benign nodule group(n=60).The diagnostic value of high-resolution CT three-dimensional reconstruction,SHOX2 and RASSF1A gene methylation in BALF for early pulmonary nodules was analyzed,and ROC curves were plotted to calculate the AUC to evaluate the diagnostic efficacy of different detection methods for early pulmonary nodules.Results:The sensitivity of SHOX2 methylation in diagno-sis of malignant nodules was50.00%,and the AUC was 0.708(P＜0.05);the sensitivity of RASSF1A methylation in diagnosis of malignant nodules was 52.50%,and the AUC was0.713(P＜0.05);the sensitivity of the combined diagnosis of the two genes meth-ylation for malignant nodules was 75.00%,and the AUC was 0.767(P＜0.05).The sensitivity and specificity of high-resolution CT three-dimensional reconstruction in diagnosing malignant nodules were 72.50%and 73.33%respectively,and the AUC was 0.729(P＜0.05).The diagnostic sensitivity and specificity of BALF for malignant nodules was 25.00%,and 100.00%respectively,and the AUC was 0.625(P＜0.05).The AUC of the combination of two gene methylation and high-resolution CT3D reconstruction for diagno-sis of malignant pulmonary nodules was 0.890,with sensitivity and specificity of 90.00%and 73.33%,respectively.Its diagnostic ef-ficacy was higher than that of the combination of two gene methylation and BALF cytology analysis and high-resolution CT 3D recon-struction+BALF cytology analysis(Z=2.453,2.736,all P＜0.05).Conclusion:The combination of high-resolution CT three-di-mensional reconstruction and SHOX2 and RASSF1A gene methylation in BALF has a high differential efficiency in the diagnosis of benign and malignant pulmonary nodules,and is worthy of clinical applica-tion.
Pulmonary nodulesHigh resolution CT3D recon-structionAlveolar lavage fluidDwarf homologous box gene 2Ras related regional family A1
NETL
NSTL
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