^(18)FDG PET对乳腺癌术后肿瘤标志物升高患者的价值

The value of ^(18)FDG PET in the follow-up of breast cancer with elevated level of tumor markers

目的探讨18FDG-PET对乳腺癌术后肿瘤标志物升高患者的价值。方法对56例乳腺癌术后肿瘤标志物(CA153和/或CEA)升高患者进行18FDG-PET显像,所得结果与最后诊断比较,计算18FDG-PET的效能。结果 40/56例病人共发现18FDG放射性增高灶197个,经组织病理(手术或活检)、详细常规影像学检查及临床随访至少9个月,最后确定是否复发或转移。18FDG-PET真阳性34例,假阳性6例,真阴性13例,假阴性3例。18FDG-PET探测乳腺癌术后复发或转移的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为91.9%(34/37)、68.4%(13/19)、83.9(47/56)、85.0%(34/40)、81.3%(13/16)。结论 18FDG PET对乳腺癌术后肿瘤标志物升高患者再分期具有重要意义,进一步影响临床管理。

Objective To evaluate the value of18 FDG PET in the follow-up of breast cancer with elevated level of tumor markers. Methods Fifty six breast cancer patients after surgery with elevated level of tumor markers（CA153 and/or CEA） were enrolled to undergo18 FDG PET. Result In 40 out of 56 patients,the18 FDG PET detected 197 sites of increased metabolic activity.These findings were confirmed by histopathology,conventional imaging examination and follow-up at least 9 months. The18 FDG PET scan was true-positive in 34 patients,false-positive in 6 patients,false-negative in 3 patients,and true-negative in 13 patients.Sensitivity,specificity,positive predictive value,negative predictive value,and accuracy were 91.9%,68.4%,83.9%,85.0%,81.3%,respectively. Conclusion The 18 FDG PET scan plays an important role in restaging breast cancer patients with rising tumor markers,with a consequent significant clinical impact on further management in these patients.