^(18)F-FDGSPECT/CT显像联合CA15-3、CA125和CEA诊断乳腺癌术后复发和(或)转移  

^(18)F-FDG SPECT/CT imaging combined with serum CA15-3,CA125 and CEA in detecting recurrence and(or) metastases in breast cancer patient after surgery

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

机构地区：[1]苏州大学附属常州肿瘤医院核医学科,江苏常州213001

出　　处：《现代肿瘤医学》2015年第23期3477-3481,共5页Journal of Modern Oncology

摘　　要：目的:探讨18F-脱氧葡萄糖(FDG)SPECT/CT显像诊断乳腺癌术后复发和(或)转移的价值及与血清糖类抗原CA15-3、CA125和癌胚抗原(CEA)单独或联合诊断的效能比较。方法:对46例乳腺癌术后患者18F-FDG SPECT/CT显像图像进行分析,计算靶/非靶(T/N)比值及诊断的灵敏度、特异性、阳性预测值、阴性预测值、准确性,并与患者同期血清CA15-3、CA125和CEA水平联合诊断结果对比。结果:18F-FDG SPECT/CT显像诊断46例乳腺癌术后复发和(或)转移的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为81.82%(18/22)、83.33%(20/24)、81.82%(18/22)、83.33%(20/24)和82.61%(38/46)。血清CA15-3、CA125和CEA的联合诊断率分别为50.00%(11/22)、95.83%(23/24)、91.67%(11/12)、67.65%(23/34)和73.91%(34/46)。两种方法联合分别为86.36%(19/22)、100.00%(24/24)、100.00%(19/19)、88.89%(24/27)和93.48%(43/46)。单独18F-FDG SPECT/CT显像和两种方法联合诊断灵敏度均明显高于血清CA15-3、CA125和CEA(P=0.026 0,P=0.009 6);两种方法联合诊断特异性明显高于18F-FDG SPECT/CT显像(P=0.036 7)。18F-FDG SPECT/CT显像示良、恶性病灶间T/N比值差异有统计学意义(5.05±11.22与1.69±0.29,t=1.724 7,P<0.05)。结论:18F-FDG SPECT/CT显像诊断乳腺癌术后复发和(或)转移有较高的临床价值,如能结合血清CA15-3、CA125和CEA诊断特异性更高。Objective： To evaluate the value of ^18F-fluorodeoxyglucose（ FDG） SPECT / CT imaging alone or combined serum carbohydrate antigen（ CA） 15-3,CA125 and carcinoembryonic antigen（ CEA） in detecting recurrence and（ or） metastases in breast cancer patient after surgery. Methods：^18F-FDG SPECT / CT imaging was performed in46 patients with breast cancer after surgery. Results of FDG SPECT / CT images were compared with serum tumor marker（ CA15-3,CA125 and CEA） during the corresponding period（ two weeks before or after ^18F-FDG SPECT /CT imaging）. Results： Of the 46 patients,22（ 47. 83%） had metastases,confirmed or endorsed by post-operation pathology,and（ or） clinical follow-up（ more than six months）. The sensitivity,specificity,positive predictive value（ PPV）,negative predictive value（ NPV）,and accuracy of ^18F-FDG SPECT / CT imaging were 81. 82%（ 18 /22）,83. 33%（ 20 /24）,81. 82%（ 18 /22）,83. 33%（ 20 /24） and 82. 61%（ 38 /46）. Those of serum tumor marker（ CA15-3,CA125 and CEA） were 50. 00%（ 11 /22）,95. 83%（ 23 /24）,91. 67%（ 11 /12）,67. 65%（ 23 /34） and 73. 91%（ 34 /46）. And those of ^18F-FDG SPECT / CT imaging combined serum tumor marker（ CA15-3,CA125 and CEA）were 86. 36%（ 19 /22）,100. 00%（ 24 /24）,100. 00%（ 19 /19）,88. 89%（ 24 /27） and 93. 48%（ 43 /46） respectively. The sensitivity of ^18F-FDG SPECT / CT imaging and^18F-FDG SPECT / CT imaging combined serum tumor marker were higher than serum tumor marker alone（ P = 0. 026 0; P = 0. 009 6）. The specificity of^18F-FDG SPECT / CT imaging combined serum tumor marker was higher than^18F-FDG SPECT / CT imaging alone（ P = 0. 036 7）. The taget /non-taget（ T / NT） values of^18F-FDG SPECT / CT imaging in detecting malignant and benign lesions were 5. 05 ±11. 22 vs 1. 69 ± 0. 29（ t = 1. 724 7,P〈0. 05）. Conclusion： ^18F-FDG SPECT / CT imaging has the highest sensitivity in detecting metastases breast cancer,and combined with serum tumor marke

关 键 词：乳腺肿瘤 SPECT/CT 放射性核素显像 脱氧葡萄糖 癌胚抗原 

分 类 号：K737.9[历史地理—历史学]