^(18)F-FDG-PET/CT对结直肠癌术后血清CEA升高患者的诊断价值

Application of ^(18)F-FDG-PET /CT for Investigating Metastasis in Post Operative Colorectal Cancer with Elavated Serum CEA

目的探讨结直肠癌术后血清癌胚抗原(CEA)升高患者行18F-FDG-PET/CT检查的临床价值。方法 98例结直肠癌患者术后血清CEA升高,腹腔超声阴性,所有患者均行PET/CT检查并与临床及病理结果比较(排除肝、肺等脏器转移患者)。分别计算结直肠癌术后CEA阳性患者PET/CT检查对腹腔转移灶的敏感性、特异性、阳性预测值和阴性预测值。结果 98例中PET阳性88例,真阳性79例,PET/CT表现腹腔转移灶呈"斑片"状及"结节"状放射性浓聚影,SUVmax 4.5～9.2,假阳性9例;10例PET阴性,3例假阴性,7例临床随访确定阴性。PET/CT对结直肠癌腹腔转移的敏感性为96.3%(79/82)、特异性为43.8%(7/16)、阳性预测值为89.8%(79/88)、阴性预测值为70%(7/10)。结论 PET/CT能敏感显示结直肠癌术后腹腔复发及转移灶,结直肠癌术后CEA升高,PET/CT阳性者可以明确转移灶的部位、大小、范围;对PET/CT阴性者则需仔细分析PET/CT扫描中的CT图像。

Objective To study the clinical value of ISFFDGPET/CT for investigating metastasis in patients with ele vated serum CEA after colorectal cancer operation. Methods 98 patients with colorectal cancer found elevated CEA were collected in the study. 18FFDGPET/CT and abdominal ultrasound were performed. PET/CT results were compared with the final histopathological and clinical followup findings. Metastasis was obviated in liver and lung post operative with colorec tal cancer. The sensitivity, specificity, PPV, NPV of ISFFDGPET/CT with abdominal metastasis were calculated. Re suits PET/CT was positive in 88 patients of 98 patients, 79 patients was true positive, the abdominal metastasis displayed radioactive concentration locally with nodular or patching shape. The value of SUVmax was from 4.5 to 9.2. Nine patients was false positive. 10 patients was false positive were consisted of 3 cases of false negative and 7 cases of true negative. The sensitivity, specificity , PPV, NPV of 18FFDGPET/CT were 96.3% ,43.8%, 89.8% and 70%, respectively. Conclu sion 1SFFDGPET/CT examination has an important clinical value in detecting recurrence and metastasis of abdominal cavity. For patients with Serum CEA increasing after operation, ISFFDGPET/CT could identify the location , size, extent of metastasis.