18F-FDG SPECT/CT在肺腺癌术后CEA增高病例诊断中的临床价值  

Diagnostic Significance of 18F-FDG SPECT/CT in Postoperative Lung Adenocarcinoma Patients with High Serum Carcinoembryonic Antigen(CEA) Levels

作　　者：贾晓娟[1] 许泽清[1] 韩军[1] 唐彩华[1] 李慧[1] 

机构地区：[1]中山大学附属第五医院,广东珠海519000

出　　处：《中外医学研究》2013年第24期74-75,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:回顾性分析18F-FDG SPECT/CT显像在肺腺癌术后血清肿瘤标志物CEA增高而CT或X线影像学检查阴性或不能提供确定诊断病例中的应用价值。方法:血清CEA升高的肺腺癌术后患者40例,常规影像学检查无异常发现或不能得出明确诊断意见。全身18F-FDG SPECT/CT显像于肿瘤标志物CEA检测值升高1周内进行。所有患者最后诊断均经手术活检病理学诊断或随访6个月以上的临床诊断。结果:40例CEA增高的肺腺癌术后病例中,18F-FDG SPECT/CT检查发现核素浓聚35例,证实复发转移病例33例。5例未见核素浓聚,随访证实1例为高分化肺腺癌术后肺内复发。18F-FDG SPECT/CT检查诊断灵敏度97.1%(33/34),特异性71.4%(5/7),准确性为92.5%(37/40),阳性预期值为94.3%(33/35),阴性预测值80.0%(4/5)。结论:对于CT等影像学检查阴性或不能提供确定诊断的肺腺癌术后血清CEA升高的患者,18F-FDG SPECT/CT全身显像具有早期诊断的价值,进而对患者的早期治疗和预后有重要意义。Objective：To analyze the clinical value of 18F-FDG SPECT/CT in high serum carcinoembryonic antigen（CEA） levels in patients with postoperative lung adenocarcinoma retrospectively.Method：40 cases of high serum CEA levels were examined with 18F-FDG SPECT/CT ,the final diagnosis was confirmed by pathology or clinical follow-up over 6 months.Result：35 cases in 40 patients with elevated CEA were positive uptake in 18F-FDG SPECT/CT,and in which 33 cases were detected relapse or metastase by pathology or clinical follow-up.1 negtive patient underwent 18F-FDG SPECT/CT screening was confirmed relapse of high differentiated lung adenocarcinoma.Sensitivity of 18F-FDG SPECT/CT was 97.1%（33/34）;specificity was 71.4%（5/7）;accuracy was 92.5%（37/40）; positive predicted value was 94.3%（33/35）;negtive predicted value was 80.0%（4/5）.Conclusion：18F-FDG SPECT/CT has early-stages diagnostic value in postoperative lung adenocarcinoma patients with high CEA levels.

关 键 词：18F-FDG SPECT CT 肺腺癌 CEA 诊断 

分 类 号：R734.2[医药卫生—肿瘤]