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卵巢癌是常见且最致命的妇科恶性肿瘤,在女性生殖系统肿瘤中其发病率占第3位,治疗后复发率约70%,预后不良[1],早期诊断发现卵巢癌术后转移或复发对病人治疗方案有很重要的意义。临床常用血浆CA125检测指标对卵巢癌随访,判断卵巢癌术后中是否发生转移或复发,其灵敏度和特异度良好,但是当病人CA125水平高于正常值时,不能在解剖学上明确肿瘤的定位诊断。另外在良性肿瘤时,如腹膜炎性病变、子宫内膜异位症等,CA125水平也会升高[2]。其在发现卵巢癌术后转移或复发仅做常规筛查作用。18F-脱氧葡萄糖正电子发射断层-计算机断层扫描(18F-FDG PET/CT,PET/CT)为解剖形态与生理及病理功能成像的新的显像设备,其全身显像可以早期探查肿瘤的转移、复发情况。本研究探讨利用PET/CT检测血CA125升高的卵巢癌病人术后转移或复发诊断的价值。现作报道。
18F-FDG PET/CT检测卵巢癌术后CA125升高病人转移或复发的效果分析
Application value of 18F-FDG PET/CT in the detection of metastasis or recurrence of ovarian cancer patients with CA125 increasing after operation
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摘要:
目的探讨18F-FDG PET/CT(PET/CT)在检测卵巢癌术后血CA125升高病人转移或复发的效果。 方法回顾32例行PET/CT检查的卵巢癌术后血CA125升高疑似转移或复发的病人,行PET/CT检查与传统影像学(CT或超声)结果比较,经再次手术或穿刺活检的病理结果或结合临床及其他影像学资料随访结果确诊。 结果PET/CT示转移或复发常见部位依次是盆腔、腹腔、胸腔;转移器官有淋巴结、肺、肝、脾脏和骨骼等;其中转移或复发病灶部位SUVmax均高于正常参考值。PET/CT的敏感度及准确度均高于传统影像学(P < 0.05和P < 0.01),特异度与传统影像学差异无统计学意义(P>0.05)。 结论PET/CT检查在卵巢癌术后转移或复发的检测中具有较高的诊断效能。 Abstract:ObjectiveTo explore the value of 18F-FDG PET/CT in detecting the metastasis or recurrence of ovarian cancer patients with serum CA125 increasing after surgery. MethodsThe clinical data of 32 suspected metastasis or recurrence ovarian cancer patients with postoperative CA125 level increasing were retrospectively analyzed.The results of 18F-FDG PET/CT were compared with traditional imaging(CT or ultrasound).The diagnosis results of patients were confirmed by the pathological examination of reoperation or puncture biopsy, and following-up data of clinical and imaging data. ResultsThe results of 18F-FDG PET/CT showed that the common sites of metastasis or recurrence were pelvis, abdominal cavity and thorax in turn, and the metastasis organs included the lymph node, lung, liver, spleen and bone.The SUVmax value of metastatic or recurrent lesions was higher than the normal reference value.The sensitivity and accuracy of 18F-FDG PET/CT were higher than those of traditional imaging(P < 0.05 and P < 0.01), but the difference of the specificity between two methods was not statistically significant(P>0.05). Conclusions18F-FDG PET/CT has a high diagnostic efficacy in the metastasis or recurrence of ovarian cancer after operation. -
Key words:
- computed tomography /
- ovarian cancer /
- metastasis or recurrence /
- traditional imaging
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