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PET/CT联合CA199、HE4在恶性孤立性肺结节筛查中的应用价值
作者:张飞飞  孙斌  吕达  姚韧寰  李慧敏  秦莎娜 
单位:内蒙古自治区人民医院 核医学科, 内蒙古 呼和浩特 010010
关键词:孤立性肺结节 恶性 正电子发射型计算机断层显像 糖类抗原CA199 人附睾蛋白4 诊断价值 
分类号:R817.4
出版年·卷·期(页码):2019·47·第一期(21-24)
摘要:

目的:探究正电子发射型计算机断层显像(PET/CT)联合糖类抗原CA199(CA199)、人附睾蛋白4(HE4)在恶性孤立性肺结节筛查中的诊断价值。方法:以98例孤立性肺结节患者作为研究对象,患者均进行PET/CT检测,采用电化学发光法检测血清CA199、HE4,以病理学诊断结果作为金标准,计算并对比单项检测以及三者联合检测诊断效能。结果:PET/CT、CA199、HE4判定恶性孤立性肺结节准确度分别为79.59%、60.20%、60.20%,敏感度分别为81.48%、61.11%、64.82%,特异度分别为77.27%、59.09%、54.55%;而三者联合检测敏感度为96.30%,特异度为84.09%,准确度为90.82%,均显著高于单项检测或CA199联合HE4检测(P<0.05)。结论:PET/CT检测的恶性孤立性肺结节的敏感度高于血清CA199、HE4单项检测,三者联合检测后能够明显提高诊断效能,为临床诊断恶性孤立性肺结节提供一定的参考。

Objective:To explore the diagnostic value of positron emission tomography-computed tomography (PET/CT) combined with carbohydrate antigen CA199 (CA199) and human epididymal protein 4 (HE4) in the screening of malignant solitary pulmonary nodules. Methods: Ninety-eight cases of solitary pulmonary nodules in our hospital were enrolled in this study, the patients were examined by PET/CT after admission andserum CA199 and HE4 were detected by electrochemiluminescence (ECL), all the patients were confirmed by pathology. The pathological diagnosis results was used as the gold standard, the diagnostic effectiveness of single test or three combined detection was calculated and compared. Results: The accuracy of PET/CT, CA199, and HE4 in determining malignant solitary pulmonary nodules was 79.59%, 60.20% and 60.20%, respectively, the sensitivity was 81.48%, 61.11%, 64.82% and the specificity was 77.27%,59.09%,54.55%,respectively. The sensitivity, specificity, and accuracy of the three combined detection were 96.30%, 84.09%,and 90.82% respectively, which were significantly higher than the single detection or CA199 and HE4 combined detection (P<0.05).Conclusion: The sensitivity of PET/CT in detecting malignant solitary pulmonary nodules is higher than that of serum CA199 or HE4. PET/CT,CA199 and HE4 combined detectioncan significantly improve the diagnostic efficiency and provide a reference for clinical diagnosis of maligant solitary pulmonary nodules.

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