摘要
目的 研究血清ALP水平及SPECT/CT在肺癌骨转移诊断中的临床价值.方法 回顾176 例NSCLC患者的影像资料,Mann-Whitney U检验分析组间ALP差异,卡方检验比较ALP和SPECT/CT诊断骨转移的效能.结果 44.32%(78/176)的NSCLC患者发生骨转移,骨转移阳性组血清ALP水平明显高于阴性组(P＜0.05).血清ALP水平诊断骨转移的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为55.64%、63.27%、59.66%、54.43%、63.92%.SPECT/CT诊断骨转移的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为74.11%、76.90%、75.57%、71.60%、78.95%.ALP联合SPECT/CT诊断骨转移的敏感性、特异性、准确率、阳性预测值、阴性预测值分别为92.88%、61.22%、75.00%、65.45%、90.91%.联合检测的敏感性、阴性预测值均优于ALP、SPECT/CT单独检测(P＜0.05).结论 血清ALP联合SPECT/CT能够提高NSCLC骨转移的诊断效能,为临床分期提供参考价值.
Abstract
Objective To investigate clinical value of serum ALP level and SPECT/CT in the diagnosis of bone metastasis of lung cancer.Methods The imaging of 176 NSCLC patients were reviewed,Mann-Whitney U test was used to analyze the difference of ALP between groups,and chi-square test was used to compare the efficacy of ALP and SPECT/CT in the diagnosis of bone metastasis.Results Bone metastasis occurred in 44.32%(78/176)of NSCLC patients,and serum ALP levels were significantly higher in the bone metastasis-positive group than in the negative group(P＜0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of serum ALP level for diagnosing bone metastasis were 55.64%,63.27%,59.66%,54.43%,and 63.92%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of SPECT/CT for diagnosing bone metastasis were 74.11%,76.90%,75.57%,71.60%,and 78.95%.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of ALP combined with SPECT/CT for the diagnosis of bone metastasis were 92.88%,61.22%,75.00%,65.45%,and 90.91%,respectively.The sensitivity and negative predictive value of the combined test were better than those of ALP and SPECT/CT alone(P＜0.05).Conclusion Level of serum ALP combined with SPECT/CT can improve the diagnostic efficacy of NSCLC bone metastasis and provide reference value for clinical staging.
基金项目
张家港市医疗科技创新指导性项目(ZKYL2226)
NETL
NSTL
万方数据