18F—FDGSPECT／CT联合血清肿瘤标志物检测在NSCLC术后复发诊断中的价值  

Clinical Values of Serum Tumor Marker Assays in Combination with 18 F - FDG SPECT/CT in the Diagnosis of Re- sectable NSCLC Recurrence

作　　者：丁晨旻 毛夕保[1] 李楠[1] 蒋凌云[1] 包文骏[1] 范晶[1] 薛宁娟[1] 

机构地区：[1]苏州大学附属常州市肿瘤医院核医学科,江苏常州213001

出　　处：《常州实用医学》2014年第2期75-78,共4页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的比较18F-脱氧葡萄糖（18F-Fluorodeoxyglucose，18F-FDG）sPECT/CT检查与血清肿瘤标志物检测对非小细胞肺癌（non-small cell lung cancer，NSCLC）术后复发的诊断价值。方法回顾分析本院33例NSCLC患者术后行18F-FDGSPECT／CT显像检查及血清肿瘤标志物癌胚抗原（carcinoembryonicantigen，CEA）、神经特异性烯醇化酶（neuro-specific enolase，NSE）、细胞角蛋白19片段（cytokeratin19fragment，CYFRA21-1）检测资料，分别计算18F-FDGSPECT／CT显像检查、肿瘤标志物CEA、NSE、CYFRA21-1检测与两者联合检测诊断NsCLC术后复发的灵敏度、特异性、准确性。结果检测NSCLC术后复发的灵敏度、特异性、准确性18F-FDGSPECT／CT显像检查分别为89．5％、84．6％、87．5％，血清肿瘤标志物联合检测分别为63．2％、100．O％、78．1％，FDGSPECT／CT联合血清肿瘤指标物检测分别为94．7％、84．6％、90．6％；FDGSPECT／CT联合血清肿瘤指标物检测灵敏度与单纯18F-FDGSPECT／CT检查相比差异无统计学意义（χ2＝0．36，P〉0．05），与单纯血清肿瘤标志物检测相比差异有统计学意义（χ2=5．72，P〈0．05），但特异性、准确性、阳性预测值和阴性预测值单独检测与联合检测比较，差异无统计学意义（P〉0．05）。结论18F-FDGSPECT／CT显像是一种准确有效的非创伤性检查方式，在NSCLC术后复发诊断中与专用PET检测相比更为经济，值得临床尤其是广大基层医院应用。The study was to compare the e/inieal value of SPECT/CT using 18F - FDG in association with serum tumor marker assays in the diagnosis of postoperative NSCLC recurrence. Mothods A retrospective evaluation of 18 F - SPECT/CT with the assessment of serum tumor markers（CEA, NSE, CYFRA21 - 1）wus performed on 33 consecutive patients with known or suspected postoperative NSCLC recurrence. The sensitivity, specificity and aceuraey of those tests were ealeulated re- spectively. ROSults The sensitivity, specificity, accuracy of 18F - FDG SPECT/CT for the diagnosis of resectable NSCLC recur- rence were 89.5 %, 84.6 % and 87.5 % respectively, those of serum tumor markers in diagnosing of resectable NSCLC reeurrenee were 63.2%, 100% and 78.1% respectively, those of serum tumor markem in combination with 18F - FDG SPECT/CT for dis- criminating resectable NSCIE recurrence were 94.7% ,84.6% and 90.6%. There were no differences of sensitivity between the combination of FDG SPECT/CT and serum tumor markers and FDG SPECT/CT（ χ2 = 0.36, P 〉 0.05）, but the sensitivity of the combination of FDG SPECT/CT and serum tumor markers was significantly higher than that of senma tumor markers（ χ2 = 5.72, P 〈 0.05）. However, there were no differences of specificity, accuracy, PPV＇（positive predictive value ） and NPV（ negative predictive value） in other groups（ P 〉 0.05）. Conclusion In this study, as a powerful and non - invasive system, FDG SPECT/CT would become mere cost - effective than dedicated FDG PET/CT in the diagnosis of resectable NSCLC recurrence, especially strongly suggested to apply widely in the basie unit hospital.

关 键 词：18F-FDG SPECT CT 血清肿瘤标志物 检测 非小细胞肺癌 术后复发 诊断 

分 类 号：R446[医药卫生—诊断学]