正电子发射断层扫描显像与血清中肿瘤标志物联合在检测尘肺合并肺癌中的诊断价值  

Diagnostic value of 18F-FDG PET /CT and serum tumor markers in pneumoconiosis combined lung cancer

作　　者：孙晓伟[1] 梁艳[1] 高燕[1] 张华[1] 陈艳霞[1] 郭建[1] 

机构地区：[1]青岛大学医学院第二附属医院,山东省青岛市266042

出　　处：《职业与健康》2014年第13期1764-1766,1775,共4页Occupation and Health

基　　金：青岛市2012年年度医药科研指导计划(项目编号:2012-WSZD072)

摘　　要：目的探讨18F-FDG PET/CT显像[(18F)氟-2-脱氧葡萄糖正电子发射体层扫描/X线计算机体层显像]与血清肿瘤标志物联合检测在尘肺合并肺癌诊断中的应用价值。方法 53例肺部病灶性质待定的尘肺患者,全部行18F-FDG PET/CT显像检查,并在1周内检测血清中肿瘤标志物癌胚抗原神经元特异性烯醇化酶(CEA、NSE、CYFRA211、CA199、CA125),分析2种检查之间的差异和相互关系。结果 18F-FDG PET/CT及血清中肿瘤标志物诊断肺癌的敏感性分别为100%,81%,特异性分别为53.1%,68.8%,约登指数分别为0.531,0.466。PET-CT显像联合血清中肿瘤标志物检测诊断肺癌的敏感性可达100%,特异性为53.1%,约登指数为0.531。原发灶最大标准摄取值(SUVmax)与CYFRA21-1有弱的相关性(r=0.209,P=0.042);在鳞癌患者中SUVmax与CYFRA21-1呈显著相关(r=0.551,P=0.041);在小细胞肺癌中,SUVmax与NSE显著相关(r=0.453,P=0.038)。结论 PET/CT诊断尘肺合并肺癌的敏感性较肿瘤标志物高,肿瘤标志物对PET/CT诊断具有补充作用,两者联合应用对于尘肺合并肺癌的诊断具有重要的临床价值。[Objective] To explore the diagnostic value of 18F-FDG PET/CT and serum tumor markers （TMs） in pneumoconiosis combined lung cancer. [ Methods] 53 cases of pneumoconiosis whose pulmonary lesions properties was pending were detected by 18F-FDG PET/CT, and the serum tumor markers { CEA, NSE, CYFRA21 l, CA199 and CA125 ） were detected within the following week. The difference and corrdations of the two methods were analyzed. [ Results] The sensitivity of 18F-FDG PET/CT and TMs in diagnosing the lung cancer were 100% and 81%, the specificity were 53.1% and 68.8% , the Youden＇ s index were O. 531 and 0. 466. The sensitivity of lgF-FDG PET/CT combined TMs diagnosing the lung cancer was 100%, the specificity was 53.1% and the Youden＇ s index were 0.531. The SUVmax of primary lesion had a weak correlation with CYFRA211 （ r = 0.209, P = 0.042 ）. The SUVmax had significantly correlation with CYFRA211 in squamous cell carcinoma patients （r = 0. 551, P = 0. 041 ）. The SUVmax had significantly correlation with NSE in small cell lung cancer （r =0.453, P =0.038 ）. [ Conclusion] The sensitivity of PET/CT in diagnosing the pneumoconiosis combined lung cancer is higher than that of TMs. And TMs has a supplementary role for PET/CT diagnosis. There is an important clinical value of two methods combined in diagnosing the pneumoconiosis combined lung cancer.

关 键 词：正电发射体层扫描 X线计算机体层显像 血清肿瘤标志物 尘肺 肺癌 诊断 

分 类 号：R135.2[医药卫生—劳动卫生]