^(18)F-FDGPET/CT联合血清鳞癌抗原在宫颈癌随访监测中的临床应用价值  

The Clinical Application Value of ^(18)F-FDG PET/CT Imaging Combined with Serum Squamous Cell Carcinoma Antigen in the Follow-up Monitoring of Cervical Cancer

作　　者：张婧[1] 汪世存[1] 潘博[1] 

机构地区：[1]安徽医科大学附属省立医院PET/CT中心

出　　处：《中国医学计算机成像杂志》2016年第5期473-477,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨宫颈癌治疗后随访监测过程中^(18)F-FDG PET/CT显像联合血清鳞癌抗原检测发现宫颈癌复发和(或)转移病灶的临床应用价值。方法:回顾性分析61名宫颈癌治疗后患者,随访过程中血清鳞癌抗原(SCC-Ag)值均大于1.5μg/L,且半个月内均行^(18)F-FDG PET/CT显像,所有复发和(或)转移病灶均经病理或临床随访证实,对所得数据进行统计学分析。结果:对于治疗后随访监测过程中SCCAg升高的宫颈癌患者,^(18)F-FDG PET/CT检出宫颈癌复发转移病灶的准确性、灵敏度、特异度、阳性预测值及阴性预测值分别为91.80%(56/61)、92.00%(46/50)、90.91%(10/11)、97.87%(46/47)及71.42%(10/14);PET/CT诊断宫颈癌复发转移病灶与病理或随访结果比较差异无统计学意义,二者结果具有高度的一致性,Kappa值为0.749。随访血清SCC-Ag升高范围1.7~23.3μg/L,血清SCC-Ag值与复发转移病灶的最大标准化摄取值(SUVmax)之间无相关性。结论:^(18)F-FDG PET/CT显像对宫颈癌治疗后随访过程中血清SCC水平升高患者的复发转移病灶检出率较高,并能较准确定位,可为临床治疗提供重要的信息。Purpose： To explore the clinical application value of ^18F-FDG PET/CT imaging combined with serum squamous cell carcinoma antigen （SCC-Ag） in the diagnosis of cervical cancer recurrence and/or metastatic lesions for cervical cancer follow-up monitoring. Method： Sixty-one cases of treated cervix cancer patients who accepted PET/CT imaging and their serum squamous cell carcinoma antigen was higher than the normal range in half a month were enrolled. Their clinical data and PET/CT imaging were analyzed retrospectively. All the recurrent metastatic lesions were confirmed by pathological exam or clinical follow-up. Result： For the diagnosis of cervical cancer recurrence and metastatic lesions, the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of ^18F-FDG PET/CT were 91.80% （56/61） , 92.00% （46/50） , 90.91% （10/11 ） ,97.87% （46/47） and 71.42% （10/14） , respectively. The diagnosis of cervical cancer recurrence and metastatic lesions in ^18F-FDG PET/CT and pathological or clinical follow-up result had a high consistency （Kappa value=0.749）. The level of serum SCC-Ag during the follow-up was 1.7-23.3 ug/L. There was no relationship between the level of serum SCC-Ag and the maximal standard uptake value of ^18F-FDG PET/CT. Conclusion： ^18F-FDG PET/CT is efficient in accurately detecting and locating the post-treatment recurrence and metastases of cervical cancer with elevated SCC-Ag, which provides important information for further treatment.

关 键 词：宫颈癌 正电子发射计算机断层成像 最大标准化摄取值 鳞状上皮细胞癌抗原 复发转移 

分 类 号：R737.33[医药卫生—肿瘤] R730.44[医药卫生—临床医学]