PET/CT在无症状肿瘤标志物升高肺癌患者中的诊断价值  

Diagnostic value of PET/CT in asymptomatic lung cancer patients with elevated tumor markers

作　　者：杜宁[1] 柴雪红[1] 徐旭 DU Ning;CHAI Xuehong;XU Xu(Department of Nuclear Medicine,Jinzhou Central Hospital,Jinzhou 121000,Liaoning,China)

机构地区：[1]锦州市中心医院核医学科,辽宁锦州121000

出　　处：《癌症进展》2018年第10期1228-1230,共3页Oncology Progress

摘　　要：目的探讨PET/CT在无症状肿瘤标志物升高肺癌患者中的诊断价值。方法回顾性分析84例经初诊疑似肺癌患者的临床资料,所有患者均无明显的临床症状,均在发现癌胚抗原(CEA)升高后1周内复查肿瘤标志物,且在确认CEA、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、糖类抗原242(CA242)和神经元特异性烯醇化酶(NSE)中至少一种升高后3周内接受PET/CT检查。分析PET/CT检查和肿瘤标志物检查结果。以病理结果为金标准,分析PET/CT诊断肺癌的灵敏度、特异度和准确度。结果 84例初诊疑似肺癌患者中,59例患者经病理学检查确诊为肺癌。在CEA单一肿瘤标志物升高的29例患者中,10例患者经PET/CT诊断为阳性,阳性诊断率为34.48%(10/29);而在CEA、CA125、CA19-9、NSE多种肿瘤标志物升高的患者中,PET/CT阳性诊断率分别为80.00%(24/30)、57.14%(12/21)、71.43%(10/14)和20.00%(1/5)。PET/CT诊断肺癌的灵敏度为91.53%,特异度为88.00%,准确度为90.48%,约登指数为0.795。结论 PET/CT对于无症状肿瘤标志物升高肺癌患者的早期诊断具有较高的阳性诊断率,且对于有多种肿瘤标志物升高的患者,可作为临床首选的检查方式,而在仅有CEA升高的人群中也有一定的诊断意义。Objective To evaluate the diagnostic value of CT in asymptomatic lung cancer patients with elevated tumor markers. Method Clinical information of eighty-four patients with initial diagnosis of suspected lung cancer were analyzed retrospectively. All patients with elevated carcinoembryonic antigen（CEA） were re-examined in 1 week to confirm that at least one of the tumor markers CEA, carbohydrate antigen 125（CA125）, carbohydrate antigen 19-9（CA19-9）,carbohydrate antigen 242（CA242）, neuron-specific enolase（NSE） was elevated before PET/CT examination, and the PET/CT examination was performed at least within 3 weeks after the elevated marker was detected. The relationship between the PET/CT examination data and the results of tumor markers were analyzed. The sensitivity, specificity and accuracy of PET/CT in the diagnosis of lung cancer were analyzed taking the pathological results as golden standard. Result Among the 84 patients with initial diagnosis of suspected lung cancer, 59 cases were diagnosed as lung cancer by pathological examination. Among the 29 patients with elevated CEA single tumor marker, 10 patients were diagnosed positive by PET/CT, and the positive diagnostic rate was 34.48%（10/29）, while in the patients with increased multiple tumor markers in CEA, CA125, CA19-9 and NSE, PET/CT positive diagnostic rates were 80.00%（24/30）, 57.14%（12/21）,71.43%（10/14） and 20.00%（1/5）. The sensitivity of PET/CT in the detection of lung cancer was 91.53%, specificity was88.0%, accuracy was 90.48%, and the index was 0.795. Conclusion PET/CT has a high positive diagnosis rate for early diagnosis on asymptomatic lung cancer patients with elevated tumor markers, and for patients with multiple elevated tumor markers can be the first choice for clinical examination, while there is also a certain diagnostic significance in the population with elevated CEA alone.

关 键 词：肺癌 肿瘤标志物 PET/CT 诊断 

分 类 号：R734.2[医药卫生—肿瘤]