PET-CT联合检测肿瘤标志物对肺癌术后随访的价值  

The clinical value of PET-CT combined with detection of serum tumor markers in followup of patients with lung cancer postoperatively

作　　者：江吕泉[1] 高坤祥[2] 郑建[1] 陈建[1] 吴昊[1] 

机构地区：[1]武警江苏总队医院胸外科,扬州225003 [2]第四军医大学唐都医院胸外科,西安710038

出　　处：《武警医学》2011年第9期744-746,749,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨肿瘤标志物和正电子发射断层/计算机断层扫描(PET-CT)对肺癌术后随访的作用及相互关系。方法 97例肺癌术后患者做全身PET-CT检查,并在1周内检测血癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白19片段(cytokeratin 19 fragment 21-1,CYFRA 21-1)和神经元特异性烯醇化酶(neuron specific enolase,NSE),同时与最终诊断进行比较,分析两种检查之间差异和相互关系。结果 97例中,89例诊断肺癌复发或转移。肿瘤标志物诊断肺癌术后复发或转移的敏感性为68.5%,特异性75.0%,准确性为69.1%;PET-CT诊断肺癌术后复发或转移的敏感性为92.1%,特异性75.0%,准确性为90.7%。两者联合诊断的敏感性为100%,特异性为92.0%,准确性为95.6%。结论 PET-CT诊断肺癌术后的复发或转移敏感性和准确性较肿瘤标志物检测高,肿瘤标志物对PET-CT诊断具有补充作用,两者联合应用对于肺癌术后的随访有重要的临床价值。Objective To study the value of and correlations between positron emission tomography/computed tomngraphy （PET/CT） and serum tumor markers in the follow - up of lung cancer after operation. Methods In 97 patients with a surgical history of lung cancer, PET/CT was performed and serum carcinoembryonic antigen （CEA） , eytokeratin 19 fragment 21 - 1 （ CYFRA21 - 1 ） and neuron specific enolase （NSE） were detected within the following week. The results were compared with the final diagnosis. The difference and correlations between the two methods of examination was analyzed. Results Recurrence or metastasis was found in 89 of the 97 patients with a surgical history of lung cancer. The sensitivity , specificity and accuracy of tumor marker detection ibr diagnosis of recurrence or metastasis were 68.5% ,75.0% and 69.1% respectively, those of PET/CT were 92.1% ,75.0% and 90.7% respectively, and those of combined PET/CT with detection of tumor markers were 100% ,92.0% and 95.6% respectively. Conclusions PET/CT has a higher sensitivity and accuracy than tumor marker detection in assessment of postoperative recurrence or metastasis of lung cancer, and tumor marker detection may be taken as a nations has an important clinical impaet on the management supplementary tool to PET/CT examination. Combined use of both examinations has an important clinical impact on the management of these patients.

关 键 词：肺癌 18F-脱氧葡萄糖 正电子发射断层 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤]