^(18)F-脱氧葡萄糖PET/CT联合血清糖类抗原125、人附睾蛋白4检测诊断卵巢恶性肿瘤的价值  

Value of ^(18)F-fluorodeoxyglucose PET/CT imaging combined with serum carbohydrate antigen 125 and human epididymis protein 4 detection in diagnosis of ovarian malignancy

作　　者：郑容亮[1,2] 胡莹莹[1,2] 张亚锐[1,2] 肖子正 龙文 李绮雯[2,3] 樊卫[1,2] 

机构地区：[1]中山大学肿瘤防治中心核医学科,广东广州510060 [2]华南肿瘤学国家重点实验室,广东广州510060 [3]中山大学肿瘤防治中心放疗科,广东广州500060

出　　处：《肿瘤影像学》2016年第1期38-44,共7页Oncoradiology

摘　　要：目的:探讨^(18)F-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)PET/CT联合血清糖类抗原125(carbohydrate antigen 125,CA125)、人附睾蛋白4(human epididymis protein 4,HE4)检测在卵巢恶性肿瘤诊断中的价值。方法:回顾性分析2013年1月—2015年1月于中山大学肿瘤防治中心1周内行^(18)F-FDG PET/CT全身显像和血清CA125、HE4检测的51例卵巢恶性肿瘤患者,以及17例卵巢良性病变患者的临床资料,对诊断效能进行研究。结果:卵巢恶性肿瘤组^(18)F-FDG PET/CT扫描呈局灶性高代谢,病灶中位最大标准摄取值(maximum standardized uptake value,SUVmax)为10.30,高于卵巢良性病变组的2.20(P<0.001)。卵巢恶性肿瘤组血清CA125及HE4中位水平分别为979.30 U/m L和490.30 pmol/L,高于卵巢良性病变组的19.60 U/m L和64.80 pmol/L(P<0.001)。^(18)F-FDG PET/CT联合CA125和HE4检测的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为84.3%、94.1%、97.7%、66.7%、86.8%。^(18)F-FDG PET/CT、CA125、HE4单独诊断和^(18)F-FDG PET/CT+CA125+HE4联合诊断的受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积分别为0.851±0.066、0.927±0.032、0.943±0.030、0.958±0.024(P<0.001)。结论:^(18)F-FDG PET/CT联合血清CA125、HE4检测诊断卵巢恶性肿瘤兼顾了诊断的灵敏度和特异度,具有更高价值。Objective: To analyze the value of ^(18)F-fluorodeoxyglucose(^(18)F-FDG) PET/CT imaging combined with serum carbohydrate antigen 125(CA125) and human epididymis protein 4(HE4) detection in the diagnosis of ovarian malignancy.Methods: A retrospective study was performed in 51 cases of malignant ovarian tumor and 17 cases of benign ovarian tumor, who received ^(18)F-FDG PET/CT imaging as well as serum CA125 and HE4 detection within a week. Results: The median maximum standardized uptake value(SUVmax) in the malignant group, whose PET/CT imaging showed high uptake of ^(18)F-FDG locally, was significantly higher than that in the benign group(10.30 vs. 2.20, P<0.001). The median serum levels of CA125 and HE4 in the malignant group were significantly higher than that in the benign group(979.30 U/ml vs. 19.60 U/ml, and 490.30 pmol/L vs. 64.80 pmol/L, P<0.001). The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT imaging combined with serum CA125 and HE4 detection were 84.3%, 94.1%, 97.7%, 66.7% and 86.8%, respectively. The areas under receiver operating characteristic curve(ROC AUC) of PET/CT, CA125, HE4 and PET/CT combined with CA125 and HE4 were 0.851±0.066, 0.927±0.032, 0.943±0.030 and 0.958±0.024(P<0.001), respectively. Conclusion: ^(18)F-FDG PET/CT imaging combined with serum CA125 and HE4 detection has clinical diagnostic value with high sensitivity and specificity.

关 键 词：糖类抗原125 人附睾蛋白4 18F-脱氧葡萄糖 正电子发射计算机断层扫描 卵巢恶性肿瘤 

分 类 号：R737.31[医药卫生—肿瘤] R730.44[医药卫生—临床医学]