Diagnostic evaluation of low-dose CT combined with serum multiple markers in early lung cancer screening
低剂量CT联合血清多重标志物在肺癌早期筛查中的诊断效能评价

摘要

目的 探讨低剂量CT（LDCT）影像特征联合血清肿瘤标志物在肺癌早期筛查中的诊断价值。方法选取2025年1月-2026年1月于我院行肺癌早期筛查的450例研究对象，经病理确诊分为实验组（肺癌患者，250例）和对照组（肺部良性病变/健康人群，200例）。所有患者接受低剂量CT和血清CEA、CYFRA21-1、CA125、CA199、ProGRP、NSE检测。通过ROC曲线分析低剂量CT、血清标志物单独及联合检测对早期肺癌的诊断价值，评估AUC、灵敏度和特异度。结果 实验组低剂量CT肺部异常检出率和血清CEA、CYFRA21-1、CA125、CA199、ProGRP、NSE水平均显著高于对照组。ROC分析显示，低剂量CT单独检测肺癌早期的AUC为0.836，灵敏度81.20%、特异度77.50%；血清多重标志物联合检测AUC为0.801，灵敏度76.80%、特异度82.00%；两者联合检测AUC达0.925，灵敏度93.60%、特异度89.00%，均显著优于单独检测。结论 低剂量CT联合血清CEA等多项标志物检测可显著提高肺癌早期筛查的灵敏度和特异性，减少漏诊误诊，是肺癌高危人群的优选筛查方案。

Abstract

Objective To investigate the diagnostic value of low-dose CT (LDCT) imaging features combined with serum tumor markers in early lung cancer screening.
Methods A total of 450 subjects who underwent early lung cancer screening at our hospital from January 2025 to January 2026 were selected. These patients were pathologically confirmed and divided into an experimental group (lung cancer patients, 250 cases) and a control group (benign pulmonary lesions/healthy individuals, 200 cases). All patients underwent low-dose CT and serum tests for CEA, CYFRA21-1, CA125, CA199, ProGRP, and NSE. The diagnostic value of LDCT, serum markers alone, and their combination in early lung cancer was evaluated using ROC curve analysis, with assessment of AUC, sensitivity, and specificity.
Results The experimental group exhibited significantly higher rates of abnormal lung detection by low-dose CT and elevated serum levels of CEA, CYFRA21-1, CA125, CA199, ProGRP, and NSE compared to the control group. ROC analysis revealed that the AUC for early-stage lung cancer detection by low-dose CT alone was 0.836, with a sensitivity of 81.20% and specificity of 77.50%. The AUC for combined detection of multiple serum markers was 0.801, with a sensitivity of 76.80% and specificity of 82.00%. The combined detection showed an AUC of 0.925, with a sensitivity of 93.60% and specificity of 89.00%, both significantly superior to individual detection. The detection rate of pulmonary abnormalities in the experimental group using LDCT and the levels of serum CEA, CYFRA21-1, and NSE were significantly higher than those in the control group. ROC analysis showed that the AUC of LDCT alone for early lung cancer detection was 0.836, with sensitivity of 81.20% and specificity of 77.50%; the AUC of combined serum marker detection was 0.801, with sensitivity of 76.80% and specificity of 82.00%; the AUC of combined detection was 0.925, with sensitivity of 93.60% and specificity of 89.00%, all significantly superior to single detection.
Conclusion   LDCT combined with serum CEA and multiple markers can significantly improve the sensitivity and specificity of early lung cancer screening, reduce missed diagnoses and misdiagnoses, and is the preferred screening protocol for high-risk populations.