摘要
目的:探讨CT影像学结合血清降钙素原(Procaicitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)水平鉴别薄壁空洞型肺结核与肺癌的价值。方法:本研究中共纳入35例薄壁囊腔型肺癌患者,将其作为肺癌组,另纳入27例薄壁空洞型肺结核患者,将其作为肺结核组。两组患者均进行CT检查,并对血清PCT、IL-6、CRP指标水平进行检测。结果:肺癌组患者年龄相较于肺结核组升高,肺癌组患者壁厚相较于肺结核组下降(均P<0.05),而两组患者病灶大小、含气腔隙大小经对比,均未见明显差异(均P>0.05);肺结核组患者血清学指标水平均相较于肺癌组上升(均P<0.05);肺结核组和肺癌组患者病灶位置、形态学分类、病灶边缘形态、含气腔隙数量、含气腔隙内壁光整度、内部结构、磨玻璃征、蜂窝征经对比,均有统计学差异(均P<0.05);受试者工作特征曲线分析结果显示,CT影像学结合血清PCT、IL-6、CRP指标鉴别薄壁空洞型肺结核与肺癌的曲线下的面积值、灵敏度、特异度及准确度分别为0.987、100.00%、88.44%、95.60%,均相较于单项检测升高。结论:CT影像学结合血清PCT、IL-6、CRP水平在对薄壁空洞型肺结核与肺癌的鉴别中,具有较高的临床价值,可为后续治疗提供参考和依据。
Objective:To investigate the value of CT imaging combined with serum Procaicitonin(PCT),Interleukin-6(IL-6)and C-reactive protein(CRP)levels in distinguishing thin-wall cavitary pulmonary tuberculosis from lung cancer.Methods:In this study,a total of 35 patients with thin-walled cystic lung cancer were included as lung cancer group,and 27 patients with thin-walled cavitary pulmonary tuberculosis were included as tuberculosis group.CT examination was performed in both groups,and the levels of serum PCT,IL-6 and CRP were detected.Results:The age of patients in lung cancer group was higher than that in pulmonary tuberculosis group,and the wall thickness of patients in lung cancer group was lower than that in pulmonary tuberculosis group(all P<0.05).However,there were no significant differences in lesion size and air space size between the two groups(all P>0.05).The levels of serological indexes in pulmonary tuberculosis group were higher than those in lung cancer group(all P<0.05).There were statistical differences in lesion location,morphological classification,lesion edge morphology,number of gas-containing cavities,inner finish of gas-containing cavities,internal structure,ground glass sign and honeycomb sign between pulmonary tuberculosis group and lung cancer group(all P<0.05).Receiver operating characteristic curve analysis results show that the area under curve value,sensitivity,specificity and accuracy of CT imaging combined with serum PCT,IL-6 and CRP were 0.987,100.00%,88.44%and 95.60%,respectively.Both were higher than single detection.Conclusion:CT imaging combined with serum PCT,IL-6 and CRP levels has high clinical value in the differentiation of thin-wall cavitary pulmonary tuberculosis and lung cancer,and can provide reference and basis for follow-up treatment.
作者
王馨悦
王珍
Wang Xin-yue;Wang Zhen(Department of Radiology,Shangqiu Municipal Hospital,Shangqiu 476000,Henan,China)
