Diagnostic value of energy spectrum CT combined with serum tumor markers in the differential diagnosis of lung adenocarcinoma and lung squamous cell carcinoma
PU Chunyan
HUA Liang
XU Yanneng
Abstract：Objective To investigate the differential diagnostic value of energy spectrum CT imaging combined with tumor markers on lung adenocarcinoma and squamous cell carcinoma.Methods The medical records of patients who visit to Guangyuan Central Hospital from May 2022 to May 2024 with suspected lung space-occupying lesions who needed to be confirmed by enhanced CT scan were retrospectively analyzed.The patients were pathologically confirmed as lung adenocarcinoma(n=78)and lung squamous cell carcinoma(n=30).energy spectrum CT imaging examination(GE Discovery 750 gemstone energy spectrum 64-slice CT scanner)and serum tumor marker detection were conducted on all patients.The energy spectrum CT imaging was compared between groups of patients.The levels of serum tumor markers were measured,and the diagnostic value of energy spectrum CT imaging combined with serum tumor markers on lung adenocarcinoma and squamous cell carcinoma was analyzed by ROC curve.Delong test was adopted to compare the difference in the area under the curve(AUC)between each single index and combined model.Results Compared with lung squamous cell carcinoma group,the proportions of peripheral type distribution,ground glass nodule and pleural depression in lung adenocarcinoma group were higher(P<0.05)while the proportions of vascular convergence sign and mediastinum invasion were lower(P<0.05).Serum tumor markers levels in lung adenocarcinoma group were lower than those in lung squamous cell carcinoma group(P<0.05).The AUC of combined detection of enhanced arterial phase CT value,venous phase CT value,carcinoembryonic antigen,neuron-specific enolase,cytokeratin 19 soluble fragment 21-1 and squamous cell carcinoma antigen was higher than that of single detection,and the above AUCs were 0.92(0.854-0.965),0.87(0.787-0.924),0.70(0.834-0.953),0.91(0.834-0.953),0.93(0.859-0.968),0.93(0.859-0.968),0.76(0.668-0.837)and 0.98(0.966-1.000)respectively,and the sensitivity and specificity of combined detection(0.97,0.96)were higher than those of single detection(0.80,0.80,0.96,0.90,0.90,0.96;0.90,0.83,0.77,0.87,0.87,0.57).Conclusion Energy spectrum CT imaging combined with tumor markers has differential diagnostic significance in the diagnosis of lung adenocarcinoma and lung squamous cell carcinoma.
Keywords：energy spectrum CTcarcinoembryonic antigencytokeratin 19 soluble fragment 21-1squamous cell carcinoma antigenlung adenocarcinomalung squamous cell carcinomadifferential diagnostic value
Publication Date：2025-08-20
Online Publishing Date：2025-09-22(First online date of this platform, not the publication date of the document)
Pages：6( 1016-1021 )