^(18)F-FDGPET-CT与肿瘤标志检测对肺癌诊断价值的分析

Diagnostic value of ^(18)F-FDG PET-CT and tumor markers in lung cancer

目的:分析18F-FDGPET-CT和肿瘤标志对肺癌的诊断价值及SUVmax与临床病理参数的关系。方法:选取152例可疑肺癌的初治患者,治疗前分别行18F-FDGPET-CT及神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)和细胞角蛋白片段(CYFRA21-1)检查,以细胞学或病理学结果为金标准分析18F-FDGPET-CT和肿瘤标志的诊断价值。结果:152例患者中,肺癌患者134例。18F-FDGPET-CT诊断肺癌的敏感性、特异性和准确性分别为96.27%、61.11%和92.11%;肿瘤标志的敏感性、特异性和准确性分别为87.31%、55.56%和81.41%,两者比较P值分别为0.008、1.000和0.024。在134例肺癌患者中,初步统计显示SUVmax与原发肿瘤大小有相关性(r=0.548,P=0.000),SUVmax在不同病理类型之间差异无统计学意义,P=0.085,SUVmax与各肿瘤标志值无相关性。结论:SUVmax在一定程度上反映原发病灶大小,18F-FDGPET-CT检查对肺癌诊断是一种灵敏可靠的方法,联合肿瘤标志综合分析能提高肺癌诊断的准确性,减少漏诊或误诊率。

OBJECTIVE： To analyse the diagnostic value of ^18F FDG PET CT and serum tumor markers （TMs） in lung cancer and the relationship between ^18F-FDG PET-CT SUVmax and clinical-pathologic factors. METHODS： An evaluation of ^18F-FDG PET-CT and the measurement of NSE, CEA and CY- FRA21-1 were performed in one week in 152 consecutive patients with suspected lung malignancies. The sensitivity, specificity and accuracy were analysed by using the cytological or pathological results as reference. RESULTS： The sensitivity, specificity and accuracy of ^18F FDG PET-CT in assessing lung cancer were 96.27%, 61.11% and 92.11%, respectively, and those of the TMs were 87. 31%, 55. 56 %and 81. 41%, respectively （P=0.008, P= 1.000, P=0.024, respectively）. SUVmax was correlated with the primary tumor size in 134 lung cancer patients （r= 0. 548, P=0. 000）, SUVmax were not significantly different in various pathological types or TMs. CON- CLUSION= SUVmax is correlated with the tumor size, ^18 F-FDG PET-CT imaging is a powerful tool for evaluating patients with lung lesions suspect of malignancy, and the combination of ^18 F-FDG PET-CT and TMs may be helpful in improving the diagnosis of lung cancer.