Hou Hongjun, Xu Zushan, Zhang Hongsheng, Xu Yan
Department of Radiology, Weihai Central Hospital, Weihai City, Shandong Province, China.
Department of Radiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China.
J Clin Lab Anal. 2018 Feb;32(2). doi: 10.1002/jcla.22250. Epub 2017 May 11.
This study was aimed to compare the diagnostic value of multi-slice spiral computed tomography (CT) and secretary phospholipase A2-IIa (sPLA2-IIa) in differentiating between malignant and benign solitary pulmonary nodules (SPNs).
A total of 223 patients with SPNs (91 patients with malignant SPNs and 132 patients with benign SPNs) were included from Weihai Central Hospital during October 2014 to December 2016. SPN diagnosis was confirmed in all patients using needle biopsy, surgery and bronchoscopy. The patients were managed with dynamic multi-slice CT scans, and their sPLA2-IIa levels were also detected. By selecting the area of interest of focus, the perfusion parameters of multi-slice CT targeting the focus were obtained.
The levels of MTT, PS, BV, BF and sPLA2-IIa significantly increased with increasing severity of SPNs (P<.05). Notably, BV (area under the ROC curve [AUC]=0.915; 95%CI: 0.88-0.95; sensitivity=91.21%; specificity=78.79%) showed a higher potential to discriminate patients with malignant SPNs from those with benign SPNs than did BF (AUC=0.712; 95%CI: 0.65-0.78; sensitivity=72.50%; specificity=59.10%), PS (AUC=0.772; 95%CI: 0.71-0.84; sensitivity=65.93%; specificity=82.58%) and MTT (AUC=0.600; 95%CI: 0.52-0.68; sensitivity=52.75%; specificity=78.03%). Finally, the combined diagnostic value of BV and sPLA2-IIa was quite ideal (AUC=0.947; 95%CI: 0.92-0.97; sensitivity=85.70%; specificity=92.70%) for malignant and benign SPNs.
The combined diagnostic value of BV and sPLA2-IIa appeared as a desirable detection method for malignant and benign SPNs.
本研究旨在比较多层螺旋计算机断层扫描（CT）和分泌型磷脂酶A2-IIa（sPLA2-IIa）在鉴别恶性和良性孤立性肺结节（SPN）方面的诊断价值。
选取2014年10月至2016年12月威海市中心医院收治的223例SPN患者（91例恶性SPN患者和132例良性SPN患者）。所有患者均通过针吸活检、手术及支气管镜检查确诊为SPN。对患者进行动态多层CT扫描，并检测其sPLA2-IIa水平。通过选取病灶感兴趣区，获得多层CT针对病灶的灌注参数。
随着SPN严重程度增加，MTT、PS、BV、BF及sPLA2-IIa水平显著升高（P<0.05）。值得注意的是，与BF（曲线下面积[AUC]=0.712；95%CI：0.65-0.78；敏感度=72.50%；特异度=59.10%）、PS（AUC=0.772；95%CI：0.71-0.84；敏感度=65.93%；特异度=82.58%）和MTT（AUC=0.600；95%CI：0.52-0.68；敏感度=52.75%；特异度=78.03%）相比，BV（AUC=0.915；95%CI：0.88-0.95；敏感度=91.21%；特异度=78.79%）在鉴别恶性SPN患者和良性SPN患者方面具有更高的潜力。最后，BV和sPLA2-IIa的联合诊断价值对于恶性和良性SPN相当理想（AUC=0.947；95%CI：0.92-0.97；敏感度=85.70%；特异度=92.70%）。
BV和sPLA2-IIa的联合诊断价值似乎是一种用于鉴别恶性和良性SPN的理想检测方法。
