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18F-FDG PET/CT 在无症状肿瘤标志物升高患者中的应用价值研究*
引用本文:付蔷,徐文贵,于筱舟,刘建井,李小凤. 18F-FDG PET/CT 在无症状肿瘤标志物升高患者中的应用价值研究*[J]. 中国肿瘤临床, 2016, 43(23): 1026-1030. DOI: 10.3969/j.issn.1000-8179.2016.23.062
作者姓名:付蔷  徐文贵  于筱舟  刘建井  李小凤
作者单位:作者单位: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300 060)
基金项目:本文课题受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)
摘    要:目的:旨在评估18F-FDGPET/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18F-FDGPET/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18F-FDGPET/CT 诊断结果之间的关系,研究18F-FDGPET/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18F-FDGPET/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。18F-FDGPET/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18F-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,18F-FDGPET/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18F-FDGPET/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18F-FDGPET/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18F-FDGPET/CT应用;而对于CA199 和CA724 单项升高的人群,不推荐首选18F-FDGPET/CT检查。 

关 键 词:18F-FDG   ?PET/CT   肿瘤标志物
收稿时间:2016-09-08

Application of 18F-fluorodeoxyglucose positron emission tomography/computed to-mography in individuals with incidental rising tumor marker asymptomatically
Affiliation:Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for China, Tianjin 300060, China
Abstract: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 fol-low-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.
Keywords:18F-FDG  PET/CT  tumor marker
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