Serum tumor markers combined with HRCT for malignancy risk assessment of solitary pulmonary nodules: a retrospective study

Introduction This study aims to investigate the correlation between serum tumor markers (CEA, NSE, CA-125, and CYFRA 21-1) and imaging findings in patients with solitary pulmonary nodules, and to assess their value in predicting the risk of malignancy. Methods A retrospective analysis was conducted on 110 patients with solitary pulmonary nodules, of whom 45 were benign and 65 were malignant. The clinical data, serum tumor marker levels, CT imaging findings, and diagnostic efficacy of single and combined tests were compared between the two groups. Results Serum levels of CEA, CA-125, CYFRA 21-1, and NSE in the malignant nodule group were significantly higher than those in the benign nodule group (P < 0.001). CT imaging revealed that patients with malignant nodules typically exhibited characteristics such as deep lobulation, pleural indentation, short fine spiculation, and multiple cystic lucencies, whereas the benign nodule group more commonly displayed pleural thickening and satellite lesions. The diagnostic efficacy of combined CT and tumor marker testing was significantly superior to that of single tests, with a sensitivity of 96.9% and an accuracy of 87.3%. The area under the curve (AUC) of the combined detection was significantly higher than that of any single indicator (P < 0.05). Discussion The combined detection of serum tumor markers and high-resolution CT imaging findings has high clinical value in the diagnosis of benign and malignant solitary pulmonary nodules, offering a more precise basis for cancer risk assessment.