摘要
目的探讨多层螺旋计算机断层扫描(CT)及胃肠道肿瘤标志物在鉴别进展期胃癌和原发性胃淋巴瘤中的可行性。方法回顾性分析24例进展期胃癌和15例原发性胃淋巴瘤患者的CT表现及胃肠道肿瘤标志物差异,CT表现评估主要包括胃周脂肪浸润、黏膜白线征、病灶强化程度、腹腔淋巴结转移,胃肠道肿瘤标志物包括癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原724(CA724),并使用受试者工作特征曲线及曲线下面积(AUC)评价诊断效能。结果进展期胃癌和原发性胃淋巴瘤患者CT表现中黏膜白线征、病灶强化程度,胃肠道肿瘤标志物中CEA比较,差异均有统计学意义(P<0.05)。CT表现、胃肠道肿瘤标志物和联合应用的AUC值分别为0.88、0.75、0.97,联合应用AUC值分别高于CT表现及胃肠道肿瘤标志物,差异均有统计学意义(P<0.05)。联合应用时灵敏度、准确度最高。结论进展期胃癌和原发性胃淋巴瘤在CT表现、肿瘤标志物上存在差异,二者联合可以为临床提供更高的鉴别诊断价值。
Objective To explore the feasibility of multi-slice spiral computed tomography(CT) and gastrointestinal tumor markers in diagnosing advanced gastric cancer(AGC) and primary gastric lymphoma(PGL).Method A retrospective analysis was performed for 24 cases with AGC and 15 cases of PGL,the CT findings and gastrointestinal tumor markers of these patients were compared;the CT examination mainly included perigastric fat infiltration,linea alba,enhancement of lesions,abdominal lymph node metastasis,and the gastrointestinal tumor markers included carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and CA724.Besides,the receiver operating characteristic(ROC)curve and area under curve(AUC) were used to evaluate the diagnostic efficacy.Result There were significant difference in terms of linea alba,enhancement of lesions in CT findings,and CE A in tumor markers between AGC and PGL patients(P<0.05).The AUC of CT findings,gastrointestinal tumor markers and their combination was 0.88,0.75,and 0.97,respectively,the combined detection had the highest AUC compared to each diagnostic measure alone(P<0.05);similarly,the combined detection was with the highest sensitivity and accuracy in differential diagnosis.Conclusion AGC and PGL are different in CT manifestations and tumor markers,detection with the combination of the two diagnostic methods can provide higher differential diagnosis value in clinical practice.
作者
王勇
崔红领
林运智
崔庆周
WANG Yong;CUI Hongling;LIN Yunzhi;CUI Qingzhou(Department of Radiology,the First Affiliated Hospital of Luohe Medical College(Luohe Central Hospital),Luohe 462000,He’nan,China)
出处
《癌症进展》
2020年第15期1585-1588,共4页
Oncology Progress
