PET/CT 联合血清MIC-1、SCC-Ag 诊断肺癌的临床效能分析

Diagnostic efficacy of PET/CT combined with serum MIC-1 and SCC-Ag in lung cancer

摘要:

目的 探讨正电子发射断层显像/X 射线计算机断层成像（PET/CT）联合血清巨噬细胞抑制因 子1（MIC-1）、鳞癌相关抗原（SCC-Ag）诊断肺癌的临床价值。方法 选取2015 年1 月-2017 年1 月武汉 市普爱医院收治的120 例疑似肺癌的患者接受PET/CT 检查，取血测定其血清MIC-1、SCC-Ag 水平。依据 病理结果分为肺癌和良性病变组。比较PET/CT、血清MIC-1、SCC-Ag 单独和联合诊断肺癌的敏感性和特 异性。结果 肺癌组和良性病变组的SUVmax 分别为（9.22±1.37）、（2.28±0.93），MIC-1 分别为（1.35±0.23） 及（0.37±0.09）ng/ml，SCC-Ag 分别为（3.89±1.02）及（0.72±0.17）ng/ml，两组比较，差异有统计学意 义（P <0.05）；PET/CT 诊断肺癌的敏感性（94.1%）高于MIC-1（77.9%）、SCC-Ag（76.5%）（P <0.05）， 特异性（48.1%） 低于MIC-1（84.6%）、SCC-Ag（82.7%）（P <0.05）；PET/CT+MIC-1、PET/CT+SCC-Ag 及PET/CT+MIC-1+SCC-Ag 3 种联合诊断方案的敏感性、特异性分别为82.4%、92.3%，79.4%、88.5%，88.2% 及100.0%（均P >0.05），PET/CT+MIC-1、PET/CT+SCC-Ag 及PET/CT+MIC-1+SCC-Ag 联合诊断肺癌的 ROC 曲线下面积分别为0.782、0.765 及0.843。结论 肿瘤标志物MIC-1、SCC-Ag 可作为PET/CT 诊断肺 癌的补充手段，三者联合能够有效改善肺癌诊断的敏感性和特异性，提高诊断效果。

Abstract:

Objective To explore the diagnostic efficacy of PET/CT combined with serum MIC-1 and SCC-Ag in lung cancer. Methods Totally 120 suspected lung cancer patients admitted into our hospital from January 2015 to January 2017 received PET/CT examination, and measurement of blood levels of MIC-1 and SCC-Ag. All patients were divided into lung cancer group and benign lesion group based on pathological results. Sensitively and specificity of different markers were identified. Results The levels of SUVmax in lung cancer and benign lesion group was (9.22 ± 1.37) and (2.28 ± 0.93), respectively; concentration of MIC-1 in cancer and benign lesion group was (1.35 ± 0.23) ng/ml and (0.37 ± 0.09) ng/ml, respectively; concentration of SCC-Ag in cancer and benign lesion group was (3.89 ± 1.02) ng/ml and (0.72 ± 0.17) ng/ml, respectively. Statistically significant difference was identified among groups (P < 0.05). The sensitivity of PET/CT was 94.1%, which was significantly higher than MIC-1 or SCC-Ag (94.1% vs 77.9%, P < 0.05; 94.1% vs 76.5%, P < 0.05. The specificity of PET/CT was 48.1%, which was significantly lower than MIC-1 or SCC-Ag (48.1% vs 84.6%, P < 0.05; 48.1% vs 82.7%, P < 0.05). The sensitivity of PET/CT+MIC-1, PET/CT+SCC-Ag, and PET/CT+MIC-1+SCC-Ag was 82.4%, 79.4%, and 88.2%, respectively; The specificity of PET/CT+MIC-1, PET/CT+SCC-Ag, and PET/CT+MIC-1+SCC-Ag was 92.3%, 88.5%, and 100.0%, respectively. No significant difference among these three groups was founded (P > 0.05). The specificity of PET/CT combined with MIC-1 and SCC-Ag was significantly higher than PET/CT alone (P < 0.05). The area under the ROC curve of PET/CT+MIC-1, PET/CT+SCC-Ag, and PET/CT+MIC-1+SCC-Ag was 0.782, 0.765, and 0.843, respectively. Conclusion Tumor markers MIC-1 and SCC-Ag may be a supplemental tool to PET/CT for diagnosis of lung cancer.