基于双层探测器光谱CT探讨肺癌的影像学特征及血清肿瘤标志物的相关性

Exploring the Correlation between Imaging Features and Serum Tumor Markers of Lung Cancer Based on Dual-Layer Detector Spectral CT

摘要: 目的：探讨肺腺癌患者的影像表现及肿瘤指标的相关因素。方法：根据光谱CT影像结果，将100例肺腺癌患者分为胸膜牵拉组49例和非胸膜牵拉组51例。比较两组患者的一般资料、临床资料、辅助检查结果。采用多因素logistic回归分析评估肺腺癌患者的影像表现及肿瘤指标的相关因素。结果：肺腺癌患者胸膜牵拉组与非胸膜牵拉组相比，二者在性别、年龄、吸烟史上未见明显差异性，在CEA、NSE、角蛋白19、空腹血糖上不存在相关性，在影像学表现上，胸膜牵拉组较非胸膜牵拉组多见毛刺征、支气管征、分叶征，影像诊断上多明确为MT，非胸膜牵拉组多可见孤立结节。多因素logistic回归分析结果显示，年龄、角蛋白19是胸膜牵拉肺腺癌患者的危险因素。结论：体检高龄患者影像学提示胸膜牵拉、毛刺征、支气管征、分叶征时，角蛋白19升高时，需提高警惕及进一步行病理穿刺明确诊断、避免漏诊。

Abstract: Objective: To investigate the related factors of imaging manifestations and tumor indicators in pa-tients with lung adenocarcinoma. Methods: According to the results of spectral CT images, 100 pa-tients with lung adenocarcinoma were divided into 49 cases in the pleural traction group and 51 cases in the non-pleural traction group. The general data, clinical data and auxiliary examination results of the two groups were compared. Multivariate logistic regression analysis was used to evaluate the related factors of imaging manifestations and tumor indicators in patients with lung adenocarcinoma. Results: Compared with the non-pleural traction group, there was no significant difference in gender, age, and smoking history between the pleural traction group and the non- pleural traction group in patients with lung adenocarcinoma, and there was no correlation in CEA, NSE, keratin 19, and fasting blood sugar. In terms of imaging manifestations, spicule signs, bron-chial signs, and lobulation signs were more common in the pleural traction group than in the non- pleural traction group, and MT was more clearly diagnosed in the imaging diagnosis, while solitary nodules were more seen in the non-pleural traction group. The results of multivariate logistic re-gression analysis showed that age and keratin 19 were risk factors for patients with pleural traction lung adenocarcinoma. Conclusion: When the imaging findings of elderly patients in physical exami-nation show pleural traction, burr sign, bronchus sign, lobulation sign, and elevated keratin 19, it is necessary to be vigilant and further perform pathological puncture to confirm the diagnosis and avoid missed diagnosis.