Diagnostic Value Of MSCT And Laboratory Examinations For Pneumonic Type Lung Cancer

Objective: To find MSCT findings and results of laboratory examinations with differential diagnostic value between pneumonic type lung cancer and benign pulmonary diseases.To assess and compare the value of MSCT,laboratory examinations and combined two diagnostic methods in the diagnosis of pneumonic type lung cancer.To study the correlation between the existence of MSCT features and concentration level of serum tumor markers among the patients of pneumonic type lung cancer.Methods: CT images,concentration level of serum tumor markers and blood leukocyte count of 43 patients with pneumonic type lung cancer and 43 patients with benign lung disease(included 12 inflammatory disease,18 tuberculosis and 13 patients with other benign diseases)from October 2016 to February 2016 in the First Hospital of Jilin University were collected.CT findings,the level of serum tumors markers and blood leukocyte count were compared between pneumonic type lung cancer group and benign pulmonary disease group.The diagnostic value of MSCT,laboratory examinations and combined two diagnostic methods were evaluated and compared by sensitivity,specificity and area under ROC curve(AUC).Correlation of existence of MSCT features and level of serum tumor markers was analyzed among the patients with pneumonic type lung cancer.All statistical analyses were performed using the IBM?SPSS?Statistics version24.0 and MedCalc? Statistical Software version 15.8.Measurement data were compared with Mann-Whitney U rank sum test and enumeration data were compared with the Chi-square test,a value of P<0.05 was considered to be statistically significant.The sensitivities and specificities of every two diagnostic methods were compared by Mc Nemar’s test(a value of P<0.05 was considered to be statistically significant),and the comparison of AUCs were performed by Hanley&McNeil(a value of P<0.01 was considered to be statistically significant).Results: 1.Existence of mixed density,air-bronchogram,cyst and honeycombing,lobulated margin,bigger or no change during follow-up are more common in lung cancer group(P<0.05),and bigger lesion(>3.0cm),cavity,liquid density,area without enhancement,gas-liquid level,calcification and increased CT value≥20Hu after enhancement are more common in benign disease group(P<0.05).Concentration of CEA,Ca242,Cyfra21-1,CEA+NSE+Cyfra21-1 and positive rate of blood leukocyte count are higher in lung cancer group,and blood leukocyte count is higher in benign disease group(P<0.05).2.The sensitivity of MSCT is 90.7%,specificity is 93.0%,and AUC is 0.964.The sensitivity of combined laboratory examinations(combined using of serum tumor maker and blood leukocyte)is 90.7%,specificity is 46.51% and AUC is 0.743.The sensitivity of combined two diagnostic methods is 86.05%,specificity is 96.67%,and AUC is 0.925.Specificity of MSCT and combined two diagnostic methods are higher than that of combined laboratory examinations.AUC of MSCT was significantly larger than that of combined laboratory examinations(Z=4.047,P<0.01);AUC of combined two diagnostic methods is significantly larger that of combined laboratory examinations(Z=4.227,P<0.01).3.Correlation of existence of MSCT features and the level of serum tumor markers was analyzed.Concentration levels of Cyfra21-1 of patients with large tumor(≥3cm)or multiple lesions,cavity,interlobar fissure displacement and pleural effusion are significantly higher(P<0.05),concentration levels of CEA,Cyfra21-1 of patients with lymph node enlargement are significantly higher,concentration levels of NSE of patients with spiculated margin are significantly lower(P<0.05).There is no correlation between the existence of other MSCT features and the concentration of serum tumor marker.Conclusion: 1.Existence of mixed density,air-bronchogram,cyst,honeycombing,lobulated margin,bigger or no change during follow-up,and higher concentration of CEA、Ca242、Cyfra21-1、CEA+NSE+Cyfra21-1 are useful in the diagnosis of pneumonic type lung cancer.Bigger lesion(>3.0cm),cavity,liquid density,area without enhancement,gas-liquid level,calcification,increased CT value ≥ 20 Hu after enhancement and higher blood leukocyte count is helpful in the diagnosis of benign pulmonary disease.2.The diagnostic value of MSCT and combined two diagnostic methods is higher than that of combined laboratory examinations,and the result of MSCT is important in the diagnosis of pneumonic type lung cancer.3.There are certain correlation between the existence of some MSCT features and higher serum tumor marker level.