^(18)F-FDG PET/CT联合肿瘤标志物诊断非ⅠA期局限性小细胞肺癌  

^(18)F-FDG PET/CT combined with tumor markers for diagnosis of non stageⅠA limited-stage small cell lung cancer

作　　者：林帅 姜雨萌 王琦[2] 姜雯雯 李超伟 靳飞 曾磊[1] 刘翠玉[1] 张海英 房娜[1] 王艳丽[1] LIN Shuai;JIANG Yumeng;WANG Qi;JIANG Wenwen;LI Chaowei;JIN Fei;ZENG Lei;LIU Cuiyu;ZHANG Haiying;FANG Na;WANG Yanli(Centre of PET/CT,Department of Molecular Imaging,Second School of Clinical Medicine,Qingdao University,Qingdao 266042,China;Department of Radiology,Second School of Clinical Medicine,Qingdao University,Qingdao 266042,China;Health Management Centre,Affiliated Qingdao Central Hospital of Qingdao University,Second School of Clinical Medicine,Qingdao University,Qingdao 266042,China)

机构地区：[1]青岛大学第二临床医学院,青岛大学附属青岛市中心医院分子影像科PET/CT中心,山东青岛266042 [2]青岛大学第二临床医学院,青岛大学附属青岛市中心医院放射科,山东青岛266042 [3]青岛大学第二临床医学院,青岛大学附属青岛市中心医院健康管理中心,山东青岛266042

出　　处：《中国医学影像技术》2023年第12期1813-1818,共6页Chinese Journal of Medical Imaging Technology

基　　金：青岛市医药卫生科研计划项目(2021-WJZD067)。

摘　　要：目的观察^(18)F-FDG PET/CT联合肿瘤标志物诊断非ⅠA期局限性小细胞肺癌(LS-SCLC)的价值。方法纳入非ⅠA期LS-SCLC 87例(LS-SCLC组)、非ⅠA期非小细胞肺癌(NSCLC)137例(NSCLC组)及48例肺炎性病变(炎性组),对比患者一般资料、肿瘤标志物水平及PET/CT表现;以logistic回归分析评估不同参数诊断非ⅠA期LS-SCLC的效能。结果3组患者年龄、神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(ProGRP)、癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCCA)及细胞角蛋白19片段(CYFRA21-1),以及病变最大径、最大标准摄取值(SUV_(max))、形态、毛刺征、长轴与支气管关系、淋巴结融合及淋巴结SUV_(max)高于原发灶占比差异均有统计学意义(P均<0.05)。联合毛刺征、NSE>23.5μg/L、ProGRP>111.8 ng/L、SCCA≤2.5μg/L及CYFRA21-1≤7.4μg/L鉴别LS-SCLC与NSCLC的曲线下面积(AUC)为0.91,均高于各单一参数(P均<0.05);联合SUV_(max)>8.1、NSE>19.4μg/L、ProGRP>72.5 ng/L和淋巴结融合鉴别LS-SCLC与肺内炎性病变的AUC为0.99,均高于单一参数(P均<0.05)。结论^(18)F-FDG PET/CT联合肿瘤标志物NSE和ProGRP有助于诊断非ⅠA期LS-SCLC。Objective To observe the value of ^(18)F-FDG PET/CT combined with tumor markers for diagnosis of non stageⅠA limited-stage small cell lung cancer(LS-SCLC).Methods Totally 87 cases of non stageⅠA LS-SCLC(LS-SCLC group),137 of non stageⅠA non-small cell lung cancer(NSCLC,NSCLC group)and 48 cases of pulmonary inflammatory lesions(inflammatory group)were enrolled.Patients'general data,tumor marker levels and PET/CT findings were comparatively analyzed.Logistic regression analysis was performed to evaluate the efficacy of parameters for diagnosing non stageⅠA LS-SCLC.Results There were significant differences of patients'age,neuron-specific enolase(NSE),pro-gastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCCA)and cytokeratin-19-fragment(CYFRA21-1),as well as of the maximum lesion diameter,maximum standard uptake value(SUV_(max)),morphology,spiculation sign,relationship between long axis and bronchus,lymph node fusion and proportion of lymph node with higher SUV max than primary lesion among 3 groups(all P<0.05).The area under the curve(AUC)of the combination of spiculation sign,NSE>23.5μg/L,ProGRP>111.8 ng/L,SCCA≤2.5μg/L and CYFRA21-1≤7.4μg/L for differentiating LS-SCLC and NSCLC was 0.91,higher than that of each single parameter(all P<0.05).AUC of the combination of SUV_(max)>8.1,NSE>19.4μg/L,ProGRP>72.5 ng/L and lymph node fusion for differentiating LS-SCLC and pulmonary inflammatory lesions was 0.99,higher than each single parameter(all P<0.05).Conclusion ^(18)F-FDG PET/CT combined with tumor markers ProGRP and NSE was helpful for diagnosing non stageⅠA LS-SCLC.

关 键 词：肺肿瘤 生物标志物 肿瘤 正电子发射断层显像 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R817.4[医药卫生—临床医学]