^(18)F-FDG显像与肿瘤标记物检测用于宫颈癌治疗后的临床监测  

Post-therapy surveillance of patients with uterine cervical cancer by using ^(18)F-FDG imaging and serum tumor marker measurement

作　　者：王茜[1] 李原[1] 高平[1] 岳明纲[1] 李河北[1] 

机构地区：[1]北京大学人民医院核医学科,100044

出　　处：《中华临床医师杂志（电子版）》2011年第23期6939-6943,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的比较18F-FDG符合线路显像与血清肿瘤标记物检测在宫颈癌术后监测肿瘤复发的临床价值;分析两种检查法之间的关系。方法对34例临床怀疑复发的宫颈癌患者的18F-FDG符合线路显像及血清卵巢癌相关抗原(CA125)、卵巢癌相关抗原2(CP2)和鳞状上皮细胞癌抗原(SCC)的资料进行回顾性分析。18F-FDG显像以扫描野内出现异常代谢增高灶为肿瘤复发依据;血清CA125和CP2均以≥35 U/ml,SCC以≥1.5μg/L为肿瘤复发指标。将18 F-FDG显像与肿瘤标记物检测结果进行对照,计算其诊断符合率,并依据最终临床诊断评价不同诊断法的诊断效能。结果 18F-FDG显像与血清CA125、CP2和SCC检测诊断结果的符合率分别为67.7%、65.4%和78.3%;血清CA125、CP2和SCC对复发性宫颈癌诊断的灵敏度分别为27.3%、37.5%和57.1%,特异度分别为85.0%、88.9%和100%,而18 F-FDG显像的灵敏度和特异度分别为100%和84.2%。结论对于复发性宫颈癌的诊断,血清SCC为相对高特异、最具诊断价值的肿瘤标记物;18F-FDG显像对复发肿瘤诊断的灵敏度优于三种肿瘤标记物;将18F-FDG显像与SCC检测联合应用将使诊断效能进一步提高。Objective To compare the diagnostic efficiency of 18F-FDG imaging and serum marker measurements in the diagnosis of recurrent disease in patients with post-surgery uterine cervical cancer,as well as to analyze the correlation between the two techniques.Methods 18F-FDG coincidence SPECT images and tumor marker measurements of serum CA125,CP2 and SCC in 34 patients with suspected recurrent uterine cervical cancer were retrospectively studied.On 18F-FDG imaging,abnormal FDG uptake occurred in scan view was judged as tumor recurrence;A cutoff value of 35 U/ml was taken as the criteria for predicting tumor recurrence for both serum CA125 and CP2,and a cutoff value of 1.5 μg/L,for serum SCC.18F-FDG imaging was correlated with that of serum CA125,CP2 and SCC,respectively,and the efficiency of diagnosing recurrent disease was evaluated in each method,based on the final clinical diagnosis.Results The diagnostic coincidence rate between the 18F-FDG imaging and serum CA125 was 67.7%,between the 18F-FDG imaging and serum CP2 was 65.4%,and between the 18F-FDG imaging and serum SCC was 78.3%,respectively.The diagnostic sensitivity for serum CA125,CP2 and SCC was 27.3%,37.5% and 57.1%,respectively,and the specificity was 85.0%,88.9% and 100%,respectively;and the sensitivity and specificity for 18F-FDG imaging was 100% and 84.2%,respectively.Conclusions For the post-therapy surveillance of patients with uterine cervical cancer,serum SCC is a high specific tumor marker and better than serum CA125 and CP2,but 18F-FDG imaging is more sensitive than tumor marker measurements.The diagnostic efficiency may be improved when combination use of 18F-FDG imaging and serum SCC measurement.

关 键 词：宫颈肿瘤 放射性核素显像 氟脱氧葡萄糖F18 肿瘤标记 生物学 

分 类 号：R737.33[医药卫生—肿瘤]