血清EBV抗体检测联合^(99m)TC-MIBI显像和MRI在诊断鼻咽癌放射治疗后复发中的价值

The detection of serum EBV antibody,^(99m)Tc-MIBI imaging and MRI in the diagnosis of nasopharyngeal carcinoma recurrence after radiotherapy

目的:探讨血清EBV抗体检测联合^(99m)Tc-MIBI显像和MRI在诊断鼻咽癌放射治疗后复发中的价值。方法:60例鼻咽癌放射治疗后患者依据病理组织活检和临床随访复发21例,随访中均行血清EBV抗体检测、^(99m)Tc-MIBI显像显像和MRI检查。分别评价三者对鼻咽癌放疗后复发检出的灵敏度、特异性和准确度进行比较。结果:联合3种检查方法诊断鼻咽癌放疗后复发的灵敏度、特异性和准确率分别为100%、97.44%、和98.33%,其中灵敏度与单一检查方法比较差异无统计学意义;特异性与亲肿瘤显像比较差异无统计学意义,但与血清EBV抗体检测和MRI检查差异均具有统计学意义;准确率与单一检查方法差异均有统计学意义。结论:联合血清EBV抗体检测、^(99m)Tc-MIBI显像和MRI在诊断鼻咽癌放射治疗后复发中具有较高的价值,三种诊断方法有各自的优缺点,三者结合起来应用,可明显提高诊断鼻咽癌放射治疗后复发的准确性。

Objective：To evaluate the value of serum EBV antibody,^99Tc-MIBI imaging and MRI in the diagnosis of nasopharyngeal carcinoma（NPC） recurrence after radiotherapy. Methods： Sixty patients who had NPC after radiotherapy were confirmed by pathology including 21 cases of local recurrence.Serum EBV antibody, ^99Tc-MIBI scintigraphy and MRI imaging in all patients were detected in which diagnostic efficacy was analysed. Results： The sensitivity,specificity and accuracy of united three methods were respectively 100%,97.44% and 98.33%. The sensitivity was no singnificant difference between united three methods and a single method. The specificity was no singnificant difference between united three methods and ^99Tc-MIBI scintigraphy,whih had singrfificant difference with EBV antibody test and MRI.The accuracy had singnificant difference between united three methods and a single method. Conclusion： United serum EBV antibody test, ^99Tc-MIBI imaging and MRI in the diagnosis of recurrence after radiotherapy have a higher value, and a single method have its advantage and disadvantage, so united three methods can improve the diagnosis of nasopharyngeal carcinoma recurrence after radiotherapy.