Clinical Study Of Preoperative CT Scan Combined With The Tumor Markers CEA And CA125 Of Lung Adenocarcinoma N2 Mediastinal Lymph Node Metastasis

Objective:To evaluate the clinical value of preoperative CT and tumor markers CEA and CA125 in the diagnosis of N2 lymph node metastasis of lung adenocarcinoma.Methods:A total of 100 patients admitted to Second Department of Thoracic Surgery,Yunnan Cancer Hospital from From January 2014 to January 2019 were enrolled in this study.100 patients were diagnosed with lung adenocarcinoma according to the final pathology report.All patients underwent CT examination and for while serum CEA,CA125 testing of all patients peripheral blood were tested by electrochemiluminescence and were treated with radical resection of lung cancer,and the lymph nodes dissected during the operation were timely sent to the pathology department for examination.The postoperative pathological diagnosis was used as the gold standard to evaluate the diagnostic value of CT,CEA,CA125 single item and combined examination for N2 lymph node metastasis.Difference statistical analysis was performed using SPSS22.0 software,and the diagnostic value was evaluated by sensitivity and specificity.Accuracy was assessed using the area under the receiver operating characteristic(ROC)curve.Results:1.Pathological examination of 100 patients suggested that there were 41 cases(41.0%)with N2 lymph node metastasis and 59 cases(59.0%)without metastasis.Serum CEA and CA125 levels in N2 lymph node metastasis group were significantly higher than those in non-metastasis group(P<0.05).Binary Logistic regression analysis showed that CEA and CA125 were independent predictors of N2 lymph node metastasis(P<0.05).2.The sensitivity of CT,CEA and CA125 in the diagnosis of N2 lymph node metastasis of lung adenocarcinoma were 85.4%,60.97%,63.41%,respectively.The specificity were 76.3%,84.74%,69.49%,respectively.The area under the receiver operating characteristic(ROC)curve were 0.808,0.756,0.705,respectively.3.The sensitivity of CT combined with CEA,CA125 in the diagnosis of N2 lymph node metastasis of lung adenocarcinoma were 82.92%,85.36%,respectively.The specificity were 79.66%,85.36%,respectively.The area under the receiver operating characteristic(ROC)curve were 0.851,0.767,respectively.4.The sensitivity of CT combined two common tumor makers(CEA and CA125)in the diagnosis of N2 lymph node metastasis of lung adenocarcinoma was 92.68%,respectively.The specificity was 71.18%,respectively.The area under the receiver operating characteristic(ROC)curve was 0.866,respectively.Conclusions:1.The sensitivity and diagnostic value of CT for the diagnosis of N2 lymph node metastasis is higher than tested by CEA,CA125 alone.Serum CEA,CA125 can be used for the auxiliary diagnosis of preoperative N2 lymph node metastasis2.Preoperative CT scan combined two the common tumor markers can improve the sensitivity of diagnosis and reduce missed diagnosis,which was higher than tested by CT or CEA,CA125 alone or CT combined with CEA,CA125,respectively.It is helpful for preoperative evaluation of N2 lymph node metastasis,so as to better select the most suitable treatment plan,and also have some clinical significance which is worthy of clinical application.