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PET/CT在卵巢癌术后监测复发/转移上的优势:与血清CA125及增强CT比较
引用本文:李光军,李 想,陈宪英. PET/CT在卵巢癌术后监测复发/转移上的优势:与血清CA125及增强CT比较[J]. 现代肿瘤医学, 2019, 0(21): 3894-3898. DOI: 10.3969/j.issn.1672-4992.2019.21.038
作者姓名:李光军  李 想  陈宪英
作者单位:中一东北国际医院核医学科,辽宁 沈阳 110001
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。

关 键 词:卵巢癌  复发/转移  PET/CT  血清CA125  增强CT

The capabilities of PET/CT in monitoring recurrence/metastasis in postoperative ovarian cancer:Comparison with serum CA125 and enhanced CT
Li Guangjun,Li Xiang,Chen Xianying. The capabilities of PET/CT in monitoring recurrence/metastasis in postoperative ovarian cancer:Comparison with serum CA125 and enhanced CT[J]. Journal of Modern Oncology, 2019, 0(21): 3894-3898. DOI: 10.3969/j.issn.1672-4992.2019.21.038
Authors:Li Guangjun  Li Xiang  Chen Xianying
Affiliation:Nuclear Medicine Department,Zhongyi Northeastern International Hospital,Liaoning Shenyang 110001,China.
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.
Keywords:ovarian cancer   recurrence/metastasis   positron emission tomography-computed tomography(PET/CT)   serum CA125   contrast-enhanced computed tomography(CECT)
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