Application Value of High-resolution CT Combined with Serum CEA,CA125 and CYFRA21-1 in Differential Diagnosis of Pathological Type of Early Lung Cancer

Zhang Yanhua; Song Qiuyue; Zhang Wei

doi:10.3969/j.issn.1004-5775.2025.18.019

Abstract：Objective:To analyze the application value of high-resolution CT combined with serum carcinoembryonic antigen(CEA),carbohydrate antigen(CA125)and cytokeratin 19 fragment(CYFRA21-1)in differential diagnosis of pathological type of early lung cancer.Methods:The clinical data of 157 patients diagnosed with early lung cancer in the hospital from May 2021 to December 2023 were collected retrospectively.Based on pathological results,patients included were assigned to the non-small cell lung cancer(NSCLC)group and the small cell lung cancer(SCLC)group.Among the 124 cases in NSCLC group,there were 68 cases of lung adenocarcinoma and 56 cases of lung squamous cell carcinoma.A total of 33 cases were included in SCLC group.The two groups were compared on CT signs,CT value,lesion diameter,and serum CEA,CA125 and CYFRA21-1 levels.The value of high-resolution CT combined with serum CEA,CA125 and CYFRA21-1 in differential diagnosis of pathological type of early lung cancer was analyzed.Results:The proportions of phyllotaxy,pleural depression sign and vacuole sign in the NSCLC group were higher than those in the SCLC group,and the differences were statistically significant(χ2=9.052,15.253,20.839,P＜0.05).The CT value of the NSCLC group was lower than that of the SCLC group,and the difference was statistically significant(t=9.875,P＜0.001).Through taking the pathological test results as the gold standard,the sensitivity of high-resolution CT in the differential diagnosis of early lung cancer pathological types was 81.45%,the specificity was 90.91%,the positive predictive value was 97.12%,the negative predictive value was 56.60,and the accuracy was 83.44%.The differential diagnosis results of the pathological types of early lung cancer by high-resolution CT were highly consistent with the pathological diagnosis results.The levels of serum CEA and CYFRA21-1 in the NSCLC group were higher than those in the SCLC group,while the level of serum CA125 was lower than that in the SCLC group.The differences were statistically significant(t=7.436,6.266,9.349;P＜0.001).ROC curve analysis showed that high-resolution CT and serum CEA,CA125,and CYFRA21-1 all have good differential diagnostic value for the pathological types of early lung cancer.Moreover,the area under the curve(AUC)and sensitivity of high-resolution CT combined with serum CEA,CA125,and CYFRA21-1 in the differential diagnosis of pathological types of early lung cancer were higher than those of their individual diagnoses(P＜0.05).Conclusion:High-resolution CT and serum CEA,CA125 and CYFRA21-1 are helpful for differential diagnosis of pathological type of early lung cancer.Besides,their combined use can achieve better diagnostic performance.