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《现代肿瘤医学》[ISSN:1672-4992/CN:61-1415/R]

期数:

2019年21期

页码:

3894-3898

栏目:

论著（影像诊断）

出版日期:

2019-09-30

文章信息/Info

Title:

The capabilities of PET/CT in monitoring recurrence/metastasis in postoperative ovarian cancer：Comparison with serum CA125 and enhanced CT

作者:

李光军; 李 想; 陈宪英

中一东北国际医院核医学科，辽宁 沈阳 110001

Author(s):

Li Guangjun; Li Xiang; Chen Xianying

Nuclear Medicine Department，Zhongyi Northeastern International Hospital，Liaoning Shenyang 110001，China.

关键词:

卵巢癌; 复发/转移; PET/CT; 血清CA125; 增强CT

Keywords:

ovarian cancer; recurrence/metastasis; positron emission tomography-computed tomography(PET/CT); serum CA125; contrast-enhanced computed tomography(CECT)

分类号:

R737.31

DOI:

10.3969/j.issn.1672-4992.2019.21.038

文献标识码:

A

摘要:

目的：探讨18F-脱氧葡萄糖(18F-FDG)PET/CT在早期发现卵巢癌术后复发/转移方面的价值，并与血清CA125检测及增强CT进行比较。方法：回顾性分析过去5年内在我院行卵巢癌二次手术，并在术前均行血清CA125、增强CT、PET/CT检查的患者36例（99个病灶）。分别计算出以患者个体为研究单位时血清CA125及PET/CT检查的阳性预测值、阴性预测值、灵敏度、特异度、准确度等参数，并比较二者在监测卵巢癌术后个体复发/转移方面的效能。采用卡方检验或Fisher确切概率法来比较增强CT、PET/CT两种方法诊断卵巢癌术后转移/复发病灶的差异性，并分别计算出以病灶为研究单位时的阳性预测值、阴性预测值、灵敏度、特异度、准确度等参数，比较二者在诊断卵巢癌术后复发/转移病灶方面的效能。结果：PET/CT诊断出34/36例复发/转移的患者，而血清CA125以0~35 U/ml为基准时仅诊断出11/36例复发/转移的患者。前者诊断卵巢癌术后复发/转移患者的阳性预测值、灵敏度、准确度明显高于后者（97%、100%、97% vs 91%、32%、33%）。PET/CT与增强CT在诊断卵巢癌术后复发/转移病灶效能方面差异具有统计学意义（P=0.037）。PET/CT能够诊断出78/99个卵巢癌术后复发/转移的真阳性病灶，而增强CT仅能够诊断出70/99个。PET/CT以病灶为研究单位的阳性预测值、阴性预测值、灵敏度、特异度、准确度均比增强CT高（94% vs 89%、62.5% vs 30%、93% vs 83%、67% vs 40%、89% vs 77%）。结论：对于符合二次手术条件的患者，PET/CT诊断卵巢癌术后复发/转移方面的价值要优于血清CA125及增强CT。

Abstract:

Objective：To study the role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography （PET/CT） in early detection of postoperative recurrence/metastasis of ovarian cancer in comparison with serum CA125 and contrast-enhanced computed tomography (CECT).Methods： We retrospectively analyzed thirty-six patients (99 lesions) who had undergone secondary cytoreductive surgery for ovarian cancer in our hospital in the past five years and who had performed serum CA125，CECT and PET/CT before secondary cytoreductive surgery.Serum CA125 and PET/CT were used to calculate based on the risk individual research unit of recurrence/metastasis，positive predictive value (PPV)，negative predictive value (NPV)，sensitivity，specificity，the accuracy of diagnosis.And then we compared these parameters with each other.Chi-square test or Fisher's exact test was used to compare the differences between CECT and PET/CT methods in the detection of metastasis/recurrence lesions of ovarian cancer after surgery.The PPV，NPV，sensitivity，specificity and accuracy of diagnosis were calculated and then we compared these parameters of CECT and PET/CT.Results：PET/CT could find out 34/36 patients with recurrence/metastasis of ovarian cancer after surgery，while serum CA125 only found out 11/36 patients.The PPV，sensitivity and the accuracy of PET/CT in diagnosis of ovarian cancer recurrence/metastasis were significantly higher than those with serum CA125 (97%，100%，97% vs 91%，32%，33%).The efficacy of PET/CT and CECT in diagnosing postoperative recurrence/metastasis of ovarian cancer lesions was statistically significant (P=0.037).PET/CT could find out 78/99 true positive lesions with recurrence/metastasis of ovarian cancer after surgery，while CECT just found out 70/99 ones.The PPV，NPV sensitivity，specificity，and the accuracy of PET/CT with lesions as the research unit were all higher than that of CECT (94% vs 89%，62.5% vs 30%，93% vs 83%，67% vs 40%，89% vs 77%).Conclusion：For patients who meet secondary cytoreductive surgery criteria，PET/CT diagnosis of ovarian cancer recurrence/metastasis is superior than serum CA125 and CECT.

参考文献/References

［1］Siegel RL，Miller KD，Jemal A.Cancer statistics，2017［J］.CA Cancer J Clin，2017，67(1)：7-30.
［2］Martin LP，Schilder RJ.Management of recurrent ovarian carcinoma：Current status and future directions［J］.Semin Oncol，2009，36(2)：112-125.
［3］Brunetti JC.Fludeoxyglucose 18F-PET-computed tomography：Management changes effecting patient outcomes in gynecologic malignancies［J］.PET Clin，2015，10(3)：395-409.
［4］Forstner R，Sala E，Kinkel K，et al.ESUR guidelines：Ovarian cancer staging and follow-up［J］.Eur Radiol，2010，20(12)：2773-2780.
［5］Ruiz-Hernandez G，Delgado-Bolton RC，Fernandez-Perez C，et al.Meta-analysis of the diagnostic efficacy of FDG-PET in patients with suspected ovarian cancer recurrence［J］.Rev Esp Med Nucl，2005，24(3)：161-173.
［6］Gu P，Pan LL，Wu SQ，et al.CA125，PET alone，PET-CT，CT and MRI in diagnosing recurrent ovarian carcinoma：A systematic review and Meta-analysis［J］.Eur J Radiol，2009，71(1)：164-174.
［7］Rochon J，du Bois A.Clinical research in epithelial ovarian cancer and patients' outcome［J］.Ann Oncol，2011，22（Suppl 7）：i16-i19.
［8］Fan XM，Zhang J，Niu SH，et al.Secondary cytoreductive surgery in recurrent epithelial ovarian cancer：A prognostic analysis with 103 cases［J］.Int J Surg，2017（38）：61-66.
［9］Zeng J，Yin J，Song X，et al.Reduction of CA125 levels during neoadjuvant chemotherapy can predict cytoreduction to no visible residual disease in patients with advanced epithelial ovarian cancer，primary carcinoma of fallopian tube and peritoneal carcinoma［J］.J Cancer，2016，7(15)：2327-2332.
［10］Wilder JL，Pavlik E，Straughn JM，et al.Clinical implications of a rising serum CA125 within the normal range in patients with epithelial ovarian cancer：A preliminary investigation［J］.Gynecol Oncol，2003，89(2)：233-235.
［11］Guo N，Peng Z.Does serum CA125 have clinical value for follow-up monitoring of postoperative patients with epithelial ovarian cancer? Results of a 12-year study［J］.J Ovarian Res，2017，10(1)：14.
［12］ZHU Yingjie,DENG Zhiyong,LU Yubo,et al.Value of 18F-FDG PET/CT imaging combined with serum CA125 in diagnosis of recurrence and metastasis of ovarian cancer after operation［J］.Shandong Medical Journal，2011，51(47)：52-53.［祝英杰，邓智勇，卢玉波，等.18F-FDG PET/CT显像联合血清CA125检测诊断卵巢癌术后复发、转移的价值［J］.山东医药，2011，51(47)：52-53.］
［13］Hogberg T，Kagedal B.Long-term follow-up of ovarian cancer with monthly determinations of serum CA125［J］.Gynecol Oncol，1992，46(2)：191-198.
［14］Rustin GJ，Marples M，Nelstrop AE，et al.Use of CA125 to define progression of ovarian cancer in patients with persistently elevated levels［J］.J Clin Oncol，2001，19(20)：4054-4057.
［15］Antunovic L，Cimitan M，Borsatti E，et al.Revisiting the clinical value of 18F-FDG PET/CT in detection of recurrent epithelial ovarian carcinomas：Correlation with histology，serum CA125 assay，and conventional radiological modalities［J］.Clin Nucl Med，2012，37(8)：e184-e188.
［16］Bhosale P，Peungjesada S，Wei W，et al.Clinical utility of positron emission tomography/computed tomography in the evaluation of suspected recurrent ovarian cancer in the setting of normal CA125 levels［J］.Int J Gynecol Cancer，2010，20(6)：936-944.
［17］Miranda ME，Villamil MR，Thomas OP，et al.Successful treatment with prednisone in a critical ill newborn with symptomatic multifocal infantile hepatic hemangioendothelioma［J］.Arch Argent Pediatr，2013，111(5)：e129-e132.
［18］Lee YJ，Kim YM，Jung PS，et al.Diagnostic value of integrated 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography in recurrent epithelial ovarian cancer：Accuracy of patient selection for secondary cytoreduction in 134 patients［J］.J Gynecol Oncol，2018，29(3)：e36.
［19］Limei Z，Yong C，Yan X，et al.Accuracy of positron emission tomography/computed tomography in the diagnosis and restaging for recurrent ovarian cancer：A meta-analysis［J］.Int J Gynecol Cancer，2013，23(4)：598-607.

备注/Memo

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更新日期/Last Update: 2019-09-30