^(18)F-脱氧葡萄糖PET/CT及血清糖类抗原125检测在卵巢癌术后复发和转移诊断中的价值  

Values of 18F-fluorodeoxyglucose PET/CT and serum carbohydrate antigen 125 in diagnosis of recurrent and metastatic ovarian cancers

作　　者：于丽娟[1] 孙艳芹[1] 徐继有[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院PET/CT-MRI中心,黑龙江哈尔滨150081

出　　处：《肿瘤影像学》2016年第1期50-55,共6页Oncoradiology

基　　金：黑龙江省自然基金重点项目(No:ZD2015017)

摘　　要：目的:探讨^(18)F-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)PET/CT及血清糖类抗原125(carbohydrate antigen 125,CA125)诊断卵巢癌术后复发及转移的价值。方法:收集101例术后行^(18)F-FDG PET/CT检查的卵巢癌患者资料,所有患者均施行肿瘤细胞减灭术及血清CA125检测(与PET/CT检查间隔时间<7 d)。复发及转移的判断以二次手术病理或穿刺病理为金标准;没有病理结果者以临床随访结果为标准(最短随访时间>6个月)。应用SPSS 18.0软件进行分析,P<0.05为差异有统计学意义。结果:^(18)F-FDG PET/CT和血清CA125对卵巢癌术后病变定性诊断的灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为94.1%、97.1%,81.8%、12.1%,91.4%、69.5%,87.1%、66.7%,90.1%、69.3%。以最大标准化摄取值(maximum standardized uptake value,SUVmax)≥2.5、SUVmax≥1.3为阈值,对卵巢癌术后复发及转移诊断的灵敏度、特异度、阳性预测值、阴性预测值和准确率分别为94.1%、95.6%,81.8%、84.8%,91.4%、92.9%,87.1%、90.3%,90.1%、92.1%。以CA125≥35 U/m L、CA125≥65 U/m L为阈值,对卵巢癌术后复发及转移诊断的灵敏度、特异度、阳性预测值、阴性预测值和诊断准确率分别为97.1%、88.2%,12.1%、72.7%,69.5%、87.0%,66.7%、75.0%,69.3%、83.2%。SUVmax与血清CA125值之间具有线性关系(R2=0.595)。结论:对于卵巢癌术后复发和转移的诊断,^(18)F-FDG PET/CT的特异度和准确率高于CA125(35 U/m L)。Objective: To evaluate the values of ^(18)F-fluorodeoxyglucose(^(18)F-FDG) PET/CT and serum carbohydrate antigen 125(CA125) in the diagnosis of recurrent and metastatic ovarian cancers. Methods: A total of 101 consecutive patients with ovarian cancer who underwent ^(18)F-FDG PET/CT after cytoreductive surgery were chosen. The serum CA125 level was detected within one week before or after PET/CT examination. The gold standard of recurrence or metastasis was based on pathological results acquired from reoperation or biopsy. For the patients without pathological results, the long-term follow-up(at least 6 months) results were set as standard. All the data analyses were carried out by software package SPSS 18.0, and P<0.05 was established as the threshold for significance. Results: The sensitivity, specificity, positive predicted value(PPV), negative predicted value(NPV) and accuracy of PET/CT and serum CA125 for recurrence and metastasis was 94.1%, 81.8%, 91.4%, 87.1%, 90.1%, and 97.1%, 12.1%, 69.5%, 66.7 %, 69.3%, respectively. When the maximum standardized uptake value(SUVmax) thresholds were set as ≥2.5 and ≥1.3, the corresponding diagnostic values were 94.1%, 81.8%, 91.4%, 87.1%, 90.1%, and 95.6%, 84.8%, 92.9%, 90.3%, 92.1%, respectively. When the thresholds were CA125 ≥35 U/ml and CA125 ≥65 U/ml, the corresponding values were 97.1%, 12.1%, 69.5%, 66.7%, 69.3%, and 88.2%, 72.7%, 87.0%, 75.0%, 83.2%, respectively. There was a linear relationship between SUVmax and serum CA125 value(R2= 0.595). Conclusion: Compared to serum CA125, ^(18)F-FDG PET/CT is a useful technique to detect recurrent and metastatic ovarian cancer in terms of specificity and accuracy.

关 键 词：卵巢癌 18F-脱氧葡萄糖 正电子发射计算机断层扫描 糖类抗原125 

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