摘要
目的 分析多层螺旋CT(MSCT)联合血清肿瘤标志物在非小细胞肺癌(NSCLC)诊断及预后中的应用价值.方法 选取我院 60 例NSCLC患者作为观察组,另选取肺部良性病变患者 60 例为对照组.比较两组血清肿瘤标志物[甲胎蛋白(AFP)、糖类抗原 125(CA125)、神经元特异性烯醇化酶(NSE)]及MSCT灌注成像参数[血容量(BV)、对比剂达峰时间(TTP)、强化峰值(PEI)]比较,评价血清肿瘤标志物及MSCT灌注成像参数对NSCLC的诊断价值,分析血清肿瘤标志物与MSCT灌注成像参数,以NSCLC患者血清肿瘤标志物及MSCT灌注成像参数平均值为界分为低水平与高水平患者,比较 NSCLC患者 3 年生存情况,分析血清肿瘤标志物及MSCT灌注成像参数对 3 年死亡危险度的影响.结果 观察组血清AFP、CA125、NSE水平及BV、PEI均较对照组高,差异有统计学意义(P<0.05);NSCLC患者血清AFP、CA125、NSE水平与MSCT定量参数BV、PEI呈正相关关系(P<0.05);绘制ROC曲线,结果显示,血清肿瘤标志物AFP、CA125、NSE及MSCT灌注成像参数BV、PEI诊断NSCLC的AUC分别为 0.763、0.833、0.709、0.816、0.714,联合诊断AUC为 0.932,较各指标单独诊断价值明显提高;血清AFP、CA125、NSE与MSCT定量参数BV、PEI高水平患者 3年病死率高于低水平患者,差异有统计学意义(P<0.05);血清AFP、CA125、NSE与MSCT定量参数BV、PEI高水平患者3 年死亡风险是低水平患者的 3.167 倍、5.654 倍、2.953 倍、3.860 倍、4.144 倍.结论 NSCLC患者血清肿瘤标志物及MSCT参数BV、PEI值明显升高,且二者关系密切,可无创、准确诊断NSCLC,预测生存情况,使得患者得到早期诊断及有效治疗,从而改善预后.
Abstract
Objective To investigate the application value of serum tumor markers combined with multilayer spiral CT(MSCT)in the diagnosis and prognosis of non-small cell lung cancer(NSCLC).Methods 60 patients with NSCLC in our hos-pital were selected as the observation group,and another 60 patients with benign lung lesions were selected as the control group.We compared the serum tumor markers[alpha-fetoprotein(AFP),glycoantigen 125(CA125),neuron-specific enolase(NSE)]and MSCT perfusion imaging parameters[blood volume(BV),contrast time to peak(TTP),peak enhancement(PEI)]be-tween the two groups so as to evaluate the diagnostic value of serum tumor markers and MSCT perfusion imaging parameters on NSCLC.We analyzed the serum tumor markers and MSCT perfusion imaging parameters,divided NSCLC patients into low level and high level patients by the mean value of serum tumor markers and MSCT perfusion imaging parameters,compared the 3-year survival of NSCLC patients,and analyzed the effect of serum tumor markers and MSCT perfusion imaging parameters on the 3-year risk of death.Results Serum AFP,CA125,NSE levels and BV,PEI were higher in the observation group than those in the control group(P<0.05);serum AFP,CA125,NSE levels of NSCLC patients were positively correlated with MSCT quantita-tive parameters,i.e.,BV and PEI(P<0.05);ROC curves were plotted,and the results showed that the AUCs of serum tumor markers,AFP,CA125,NSE and MSCT perfusion imaging parameters,BV and PEI,were 0.763,0.833,0.709,0.816,0.714,respectively,and the combined diagnostic AUC was 0.932,which was significantly higher than the diagnostic value of each in-dex alone;the AUC of serum AFP,CA125,NSE and MSCT quantitative parameters,BV and PEI,were 0.763,0.833,0.709,0.816,0.714 and 0.932,respectively.The 3-year morbidity and mortality rate was higher in patients with high levels than those with low levels(P<0.05);the 3-year risk of death was 3.167,5.654,2.953,3.860 and 4.144 times higher in patients with high levels of serum AFP,CA125,NSE and MSCT quantitative parameters BV and PEI than in patients with low levels.Conclu-sion The values of serum tumor markers and MSCT parameters(BV and PEI)are significantly higher in NSCLC patients,and they are closely related,which can diagnose NSCLC non-invasively and accurately,predict survival,and enable patients to re-ceive early diagnosis and effective treatment,thus improving prognosis.
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