Diagnostic value of multi-slice spiral CT perfusion imaging combined with serum CYFRA21-1, CEA and NSE for peripheral non-small cell lung cancer / 解放军医学杂志

ABSTRACT

Objective To investigate the diagnostic value of multi-slice spiral CT (MSCT) perfusion imaging combined with serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) for peripheral non-small cell lung cancer (NSCLC). Methods Based on diagnosis, 109 patients with suspected peripheral NSCLC admitted from Aug. 2017 to Aug. 2019 in the Xinxiang Central Hospital were divided into peripheral NSCLC group (n=65) and benign pulmonary nodule group (n=44). Another 56 healthy subjects undergone physical examination during the same period were selected as control group. The parameters of MSCT perfusion imaging and serum levels of CYFRA21-1, CEA and NSE in the 3 groups were compared. The receiver operating curve (ROC) was used to analyze the diagnostic value of MSCT perfusion imaging combined with serous levels of CYFRA21-1, CEA and NSE for peripheral NSCLC. Results The blood volume (BV) was larger in peripheral NSCLC group than those in benign pulmonary nodule group and control group [(10.76±1.26) ml/100 mg vs. (4.01±0.59) ml/100 mg and (2.32±0.42) ml/100 mg]; the same was for surface permeability (PS) [(42.56±5.60) ml/ (100 mg·min) vs. (16.13±1.88) ml/(100 mg·min) and (8.49±0.91) ml/(100 mg·min)]; and for the mean transit time (MTT) of contrast medium [(20.14±3.67) s vs. (12.85±1.49) s and (7.21±0.95) s]. All the BV, PS and contrast medium MTT were higher (larger) in benign pulmonary nodule group than those in control group (P<0.05). The serum level of CYFRA21-1 was higher in peripheral NSCLC group than that in benign pulmonary nodule group and control group [(8.94±1.67) ng/ml vs. (4.73±0.51) ng/ ml and (1.93±0.26) ng/ml]; the same was for the CEA level [(27.91±3.25) ng/ml vs. (7.88±0.92) ng/ml and (2.06±0.47) ng/ml]; and for the NSE level [(19.53±2.16) ng/ml vs. (15.02±1.74) ng/ml and (11.96±1.22) ng/ml]. All the serum levels of CYFRA21-1, CEA and NSE were higher in benign pulmonary nodule group than those in control group (P<0.05). The ROC results showed that the diagnosis of peripheral NSCLC alone and combined with MSCT perfusion imaging, serum levels of CYFRA21-1, CEA and NSE were 0.802, 0.794, 0.698, 0.712 and 0.841, respectively. The diagnostic value of combined detection of the four methods was higher than that of individual detection. Conclusion MSCT perfusion imaging combined with serum levels of CYFRA21-1, CEA and NSE have high diagnostic value for peripheral NSCLC.