Abstract: ［Abstract］ Objective〖HTSS〗〓To study the effect of highresolution CT(HRCT) combined with serum tumor markers detection in diagnose of solitary pulmonary nodule(SPN).
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twentysix cases of malignant SPN patients were selected as observation groups, 98 cases of benign SPN patients from the same time were selected as control group. Serum lung cancer markers were combined into four groups:carcino embryonic antigen(CEA), squamous cell carcinoma(SCC), neuronspecific enolase(NSE), cytokeratin19fragment 211(CYFRA211) detection and HRCT detection. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of HRCT, serum tumor markers and their combined detection were evaluated according to the gold standard of pathological results.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓SPN pathological results showed that 59 cases of adenocarcinoma, 42 cases of squamous cell carcinoma, 16 cases of bronchioloalveolar carcinoma and 9 cases of small cell carcinoma. On HRCT signs, the detection rates of typical nodules with deep lobulation, pleural depression, short and fine spikes, vacuole sign, bronchial vascular cluster sign and spinous process in malignant group were higher than those in benign group, while the detection rates of adjacent pleural thickening and satellite oven in benign group were higher than those in malignant group(P＜005). The levels of serum CEA, SCC, NSE and CYFRA211 in malignant group were higher than those in benign group(P＜005). The sensitivity of combined examination was the highest among the three methods, but the specificity was the lowest, the accuracy of tumor markers was the lowest, HRCT and combined examination were similar; the positive predictive value of HRCT was the highest, and the negative predictive value was lowest with the detection of tumor markers.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Joint examination has the highest sensitivity and the lowest specificity. We should pay attention to the identification of false positive rate, comprehensive evaluation of various indicators, HRCT examination indicators are relatively constant, and have higher diagnostic value in clinic. Detection of tumor markers combined with HRCT examination will greatly improve the diagnostic value, which is worthy of clinical promotion.

Key words: solitary pulmonary nodule, highresolution CT, tumor markers, diagnosis