^(18)F-FDG PET/CT、CA19-9对胰腺癌的诊断价值

Diagnostic value of ^(18)F-FDG PET/CT and CA19-9 in pancreatic cancer

目的探讨18F-脱氧葡萄糖正电子发射体层摄影术(FDG PET)/CT、糖类抗原19-9(CA19-9)对胰腺癌的诊断价值。方法 55例B超、CT、MRI发现胰腺占位患者均行全身18F-FDG PET/CT显像及血清CA19-9肿瘤标志物检查。结果在55例胰腺病变患者中,胰腺癌35例,良性病变20例。胰腺癌与胰腺良性病变平均标准摄取值(SUV)差异有统计学意义(t=3.543,P=0.001);胰腺癌与胰腺良性病变血清CA19-9水平差异有统计学意义(t=2.211,P=0.034)1。8F-FDG PET/CT对胰腺癌诊断灵敏度、特异性、阳性预测值、阴性预测值、准确性分别为97.1%、80.0%、89.5%、94.1%、90.9%。CA19-9对胰腺癌的诊断效能均低于18F-FDG PET/CT,但二者联合可以提高18F-FDG PET/CT诊断的特异性(90.0%),而准确性仅有轻微下降(87.3%)。结论 18F-FDG PET/CT对胰腺癌的诊断具有高灵敏度和相对特异性;18F-FDG PET/CT联合CA19-9检查能够提高诊断胰腺癌的特异性。

Objective To discuss the diagnostic value of ^18F-fluorodeoxyglucose（^18F-FDG）PET/CT and CA19-9 in pancreatic cancer.Methods55 patients with space-occupying lesions of the pancreas confirmed by B ultrasound,CT or MRI were selected for this study.Whole body ^18F-FDG PET/CT scanning was performed and the level of serum CA19-9 was measured.ResultsAmong 55 patients with space-occupying pancreatic lesions,35 patients were diagnosed as pancreatic cancers,and other 20 patients as benign diseases.The values of mean SUV and CA19-9 were significantly different between pancreatic cancers and benign diseases（t=3.543,P=0.001,t=2.211,P=0.034）respectively.The sensitivity,specificity,positive and negative predictive value,accuracy of ^18FDG PET/CT was,respectively,97.1%,80.0%,89.5%,94.1% and 90.9%.The diagnostic value of CA19-9 was lower than that of ^18F-FDG PET/CT,while combined application the diagnosis specificity increased to 90.0%,with only a slight decreasing in diagnosis accuracy（87.3%）.Conclusion^18F-FDG PET/CT has high sensitivity in diagnosis of pancreatic cancer and relative specificity,which would increase the diagnosis specificity combined with CA19-9.