Diagnostic value of arrival time difference between the lesion and lung tissue combined with serum tumor markers in peripheral lung lesions / 中华超声影像学杂志

ABSTRACT

Objective:To explore the value of contrast-enhanced ultrasound(CEUS) in the diagnosis of peripheral pulmonary lesions, and the diagnostic efficiency of CEUS combined with multiple tumor markers in the diagnosis of peripheral lung malignancy.Methods:A total of 76 patients with peripheral lung lesions treated in Chongqing University Three Gorges Hospital from September 2019 to September 2021 were included. According to the pathological results, the 76 patients with 76 peripheral lung lesions were divided into malignant lesions (48 cases) and benign lesions (28 cases). After contrast agent injection, the arrive time (AT), difference of AT between the lesion and lung tissue(tAT) were analyzed quantitatively. The ROC curve was plotted to calculate the area under the curve and the optimum threshold. Serum cyrokeratin fragment antigen 21-1(CYFRA21-1), carcino-embryonic antigen(CEA) and neuron specific enolase(NSE) level were detected and analyzed between the two groups, and the diagnostic efficacies of tAT combined with 3 serum tumor markers and 4 combined markers for peripheral pulmonary malignant lesions were analyzed.Results:AT and tAT of malignant lesions were greater than those of benign lesions, and the differences were statistically significant (all P<0.05). The area under the ROC curve (0.759) of tAT in the diagnosis of peripheral pulmonary malignant lesions was greater than that of AT (0.675), and the best cut-off point was 2.5 seconds (later arrival signified malignancy), the sensitivity of tAT in the diagnosis of peripheral pulmonary malignant lesions was 91.7%, and it was higher than AT, which showed more reliable diagnostic value for peripheral pulmonary malignant lesions. When tAT was combined with 3 serum tumor markers in the diagnosis of peri-pulmonary malignant lesions, the area under the combined diagnosis curve was the largest (0.878) and the sensitivity was the highest (97.9%). Conclusions:tAT is of certain value in the differential diagnosis of benign and malignant peripheral pulmonary lesions. Combination of tAT with multiple serum tumor markers can improve the diagnostic efficiency of peripheral pulmonary malignant lesions.