无创联合检查对原发性肺癌的诊断价值

Non-invasive comprehensive method for diagnosis of primary lung cancer

摘要:

目的 探讨无创综合诊断方法对原发性肺癌的诊断价值。方法 回顾性分析120例可疑肺癌患者的门诊病历资料。结合临床症状分析综合应用各种无创检查（胸部X线、CT、血清肿瘤标记物、痰脱落细胞学）联合诊断肺癌的灵敏度、特异度。结果 单从典型临床症状诊断肺癌的灵敏度为11.8%、特异度为25.9%、正确率为15%、误诊率（假阳性率）为74.1%、漏诊率（假阴性率）88.2%。临床症状＋影像学检查诊断肺癌的灵敏度为46.2%、特异度为40.7%、正确率为45.0%、误诊率为59.3%、漏诊率53.8%。临床症状＋影像学检查＋血清肿瘤标记物＋痰细胞学检查, 诊断肺癌的灵敏度为80.7%、特异度为77.8%、正确率为80%、误诊率22.2%、漏诊率19.3%。结论 临床症状、影像学检查、血清肿瘤标记物及痰脱落细胞学的无创综合诊断方法诊断肺癌具有较高的灵敏度及特异度, 门诊医生应加强筛查意识,增加肺癌的检出率。

Abstract:

Objective To investigate the value of non-invasive comprehensive method in diagnosis of primary lung cancer. Methods Medical data of 120 out-patients suspicious for primary lung cancer were analyzed retrospectively. The sensitivity and specificity of non-invasive comprehensive examination method (including chest X-ray, CT, tumor markers, cytology of sputum) for diagnosis of lung cancer were analyzed. Results The sensitivity and specificity only based on clinical symptoms for diagnosis of lung cancer were 11.8% and 25.9% respectively, accuracy 15.0%, false positivity rate 74.1%, and false negativity rate 88.2%. The sensitivity and specificity based on clinical manifestations plus imaging data were 46.2% and 40.7% respectively, accuracy 45.0%, false positivity rate 59.3%, and false negativity rate 53.8%. The sensitivity, specificity and accuracy based on clinical manifestations plus imaging data plus tumor markers plus cytology of sputum reached up to 80.7%, 77.8%, and 80.0% respectively, and the false positivity rate and false negativity rate decreased to 22.2% and 19.3% respectively. Conclusions The non-invasive comprehensive method including clinical symptoms, radiological examinations, tumor markers and sputum cytology has a high sensitivity and specificity for diagnosis of primary lung cancer. The clinicians should give emphasis to the screening of lung cancer to increase its detection rate.