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血清自身抗体联合低剂量螺旋CT在肺癌早期筛查中的价值

Diagnosis Value of Tumor-associated Auto-antibodies Combined with Low-dose Spiral Computed Tomography in Early Lung Cancer Screening

  • 摘要:
    目的 探讨血清自身抗体检测联合低剂量螺旋CT(LDCT)在肺癌早期筛查中的可行性。
    方法 收集武汉大学人民医院体检中心体检人群12 568例体检资料,男7 453例、女5 115例,筛选出肺癌高危人群1 324例纳入本研究,该人群均进行胸部X线检查。随机选取443例患者采用低剂量螺旋CT检测; 488例患者采用血清自身抗体进行检测; 393例患者采用血清自身抗体联合低剂量螺旋CT检测。均随访一年,比较不同筛查方法对肺结节初筛阳性率及肺癌确诊率,早期肺癌筛查的敏感度及特异性。
    结果 血清自身抗体联合低剂量螺旋CT检测对于发现肺结节的初筛率、肺癌的确诊率及不同直径肺结节的检出率均明显高于低剂量螺旋CT组及血清自身抗体检测组(P < 0.001)。血清自身抗体联合低剂量螺旋CT检测的特异性为89.1%,敏感度为88.4%,AUC为0.863。
    结论 血清自身抗体检测联合低剂量螺旋CT可明显提高高危人群早期肺癌筛查的确诊率,为寻找肺癌筛查路径提供理论依据。

     

    Abstract:
    Objective To investigate the application value of serum auto-antibody detection combined with low-dose spiral computed tomography (LDCT) in early lung cancer screening.
    Methods From 12568 medical examination crowd (7453 males and 5115 females), 1324 people with high-risk cases of lung cancer in our medical examination center were divided randomly into three groups (LDCT, serum auto-antibody, and serum auto-antibody combined with LDCT groups). All people in this research were screened by chest X-ray. Follow-up was conducted for one year, and the positive screening and diagnosis rates of early lung cancer screening were compared between these groups of high-risk people with lung cancer.
    Results The positive screening and diagnostic rates of high-risk lung cancer in the serum auto-antibody combined with LDCT group was significantly higher those that in other two groups (P < 0.001). The specificity and sensitivity of serum auto-antibody combined with LDCT group were 89.1% and 88.4%, respectively; the area under the ROC curve was 0.863.
    Conclusion Serum auto-antibody detection combined with low-dose spiral CT can significantly improve the positive screening rate of lung cancer in high-risk populations, providing a strong theoretical support for lung cancer screening pathway.

     

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