18F—FDGPET／CT及血清CEA在结直肠癌患者术后监测中的价值

The Value of Postoperative Monitoring by 18F-FDG PET/CT and Serum CEA on Patients with Colorectal Cancer

目的 评价18F-FDG PET/CT及血清CEA在结直肠癌患者术后监测中的价值.方法 回顾性分析69例结直肠癌术后的患者.入组的患者均有血清CEA测定、18F-FDG PET/CT检查等完整的随访资料.将患者根据CEA正常值分为两组,比较两组PET/CT检测病灶的多少.通过勾画ROC曲线得到CEA最佳截取值,将患者根据CEA最佳截取值分为两组,比较两组病人的生存期.根据全身最高处SUVmax值及18F-FDG PET/CT检测病灶多少分组,比较不同分组病人的生存期.结果 在不同CEA分组中18F-FDG PET/CT检测到肝转移、腹盆腔种植转移、腹盆腔淋巴结转移及其他（脑、骨骼、肾上腺、脾等转移）四个方面差异有统计学意义（P〈0.05）,而复发及肺转移两方面差异无统计学意义（P〉0.05）.通过勾画ROC曲线,得到预测复发及转移的血清CEA最佳截取值为2.925 ng/mL,以2.925 ng/mL为界对病人进行生存分析,差异有统计学意义（P〈0.05）.对全身最高处SUVmax值、病灶分组后进行生存分析,差异有统计学意义（P〈0.05）.结论 18F-FDG PET/CT及血清CEA检测可以更全面地监测结直肠癌患者术后复发转移及生存预后状况.

： Objective To study the value of postoperative monitoring by 18F-FDG PET/CT and serum CEA on patients with colorectal cancer. Methods 69 patients with colorectal cancer after surgery were included in this retrospective analysis. Patients enrolled in the study had complete follow-up data about serum CEA and 18F-FDG PET/CT. To compare the number of lesions detected by PET/CT, the patients were divided into two groups according to the normal value of CEA. The patients were divided into different groups according to the cut-off value of CEA obtained by the ROC curve, SUVmax value and lesions sites, survival analysis was conducted. Results The cut-off value of CEA obtained by the ROC curve was 2.925 ng/mL. Survival analysis based on 2.925 ng/mL showed there was significant difference （P 〈 0.05）. The number of lesion sites including liver metastasis, abdominal implant, abdominal pelvic lymph node metastasis and other metastasis was signifcantly different between the two groups divided according to the CEA level. However, there was no significant difference （P 〉 0.05） in recurrence and lung metastasis. Conclusion 18F-FDG PET/CT and serum CEA were useful in recurrencedetection and survival prognosis in patients with colorectal cancer.