^(18)F-FDG PET/CT在无症状肿瘤标志物升高患者中的应用价值研究  

Application of ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography in individuals with incidental rising tumor marker asymptomatically

作　　者：付蔷[1] 徐文贵[1] 于筱舟 刘建井[1] 李小凤[1] 

机构地区：[1]天津医科大学肿瘤医院分子影像与核医学诊疗科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津市恶性肿瘤临床医学研究中心,天津市300060

出　　处：《中国肿瘤临床》2016年第23期1026-1030,共5页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金项目(编号:81501984);天津市卫生局科技基金项目(编号:2015KZ084)资助~~

摘　　要：目的:旨在评估^(18)F-FDG PET/CT在无症状肿瘤标志物升高患者中的应用价值。方法:选取2008年6月至2015年7月间至少有一项肿瘤标志物升高后于天津医科大学肿瘤医院行^(18)F-FDG PET/CT检查的受检者183例,并对所有受检者进行随访,分析肿瘤标志物升高与^(18)F-FDG PET/CT诊断结果之间的关系,研究^(18)F-FDG PET/CT在无症状肿瘤标志物升高患者中的应用价值。结果:统计分析显示^(18)F-FDG PET/CT诊断阳性患者43例,其中真阳性患者34例,最常见的阳性部位为肺部,其次为肠道。^(18)FFDG PET/CT在CEA,CA199和(或)CA242升高患者中具有较好的阳性诊断准确率,其中单项CEA升高的^(18)F-FDG PET/CT阳性诊断准确率为13.0%、灵敏度为79.0%;CEA或CA242单项高水平异常时,^(18)F-FDG PET/CT阳性诊断准确率与其升高水平相关。多项肿瘤标志物升高时,如果包含CA242或CA724,则^(18)F-FDG PET/CT阳性诊断准确率与升高肿瘤标志物的个数相关。结论:CEA或CA242单项高水平异常时,推荐进行^(18)F-FDG PET/CT检查;当多项肿瘤标志物升高时,若其中包含CA242或CA724,倾向于推荐^(18)F-FDG PET/CT应用;而对于CA199和CA724单项升高的人群,不推荐首选^(18)F-FDG PET/CT检查。Objective：To evaluate the application of ^18F-fluorodeoxyglucose positron emission tomography/computed tomography （^18 F-DG-PET/CT） in asymptomatic people with rising tumor markers incidentally found during plysical examination. Methods：A total of 183 people with at least one kind of firmly rising tumor marker and without undergoing any other type of previous examinations from June 2008 to July 2015 were selected. The role of PET/CT imaging in these patients was retrospectively analyzed after long-term clinical follow-up. Results： ^18F-FDG-PET/CT detected 43 positive patients, of which 34 were confirmed to have a malignant disease;the most com-mon malignant disease was lung cancer.^18F-FDG-PET/CT had a better detection rate in people with rising CEA, CA199, and CA242. A few partial individuals with single rising CEA are expected to be detected by PET/CT, with a detection rate of 13.0%and a sensitivity of 79.0%. Moreover, the high level of CEA and CA242 was correlated with the detection rate of ^18F-FDG PET/CT scan. In individuals with multiple types of rising tumor markers, who are classified as the group with rising CA242 and CA724, the number of rising tumor mark-ers was significantly correlated with the detection rate of PET/CT scan. Conclusion：We tend to recommend the application of ^18F-FDG-PET/CT in asymptomatic people with rising tumor markers, especially in those with rising CA724 and CA242, as well as a high level of CEA and CA242. However, the effectiveness of ^18F-FDG-PET/CT was questionable for people with a single abnormality of CA199 and CA724. Therefore, we recommend other types of examination prior to ^18F-FDG-PET/CT.

关 键 词：^18F—FDG PET/CT 肿瘤标志物 

分 类 号：R730.44[医药卫生—肿瘤]