^(18)F-脱氧葡萄糖正电子发射计算机断层显像/CT与血清糖类抗原19-9、糖类抗原72-4对胃癌术后复发转移的诊断价值

Diagnostic value of ^(18)F-fluorodeoxyglucose position emission tomography/CT,F-serum carbohydrate antigen 19-9 and carbohydrate antigen 72-4 for postopera tive recurrence and metastasis of gastric cancer

目的 探讨^(18)F-脱氧葡萄糖正电子发射计算机断层显像/CT(^(18)F-FDG PET/CT)与血清糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)对胃癌术后复发转移的诊断价值。方法 选取82例确诊胃癌术后复发转移患者作为复发转移组,另选取70例经临床病理检查排除复发转移的胃癌术后患者作为未复发转移组,均行18F-FDG PET/CT检查和血清CA19-9、CA72-4检测。绘制受试者工作特征(ROC)曲线,分析^(18)F-FDG PET/CT图像与血清CA19-9、CA72-4检测对胃癌术后复发转移的诊断价值。结果 ^(18)F-FDG PET/CT图像诊断胃癌术后复发转移的曲线下面积(AUC)为0.848(95%CI:0.752~0.918),灵敏度为77.78%,特异度为91.89%。复发转移组患者血清CA19-9、CA72-4水平均明显高于未复发转移组,差异均有统计学意义(P﹤0.01)。血清CA19-9、CA72-4单独及联合检测诊断胃癌术后复发转移的AUC分别为0.835、0.822、0.923。结论 ^(18)F-FDG PET/CT图像可清晰显示胃癌术后复发转移情况,对胃癌术后复发转移具有较高的诊断价值,血清CA19-9、CA72-4联合检测对胃癌术后复发转移具有较高的筛查价值。

Objective To explore the diagnostic value of ^(18)F-fluorodeoxyglucose position emission tomography/CT(^(18)F-FDG PET/CT),serum carbohydrate antigen 19-9(CA19-9)and carbohydrate antigen 72-4(CA72-4)for postopera-tive recurrence and metastasis of gastric cancer.Method A total of 82 patients with recurrence and metastasis after gas-tric cancer surgery were enrolled as the recurrence metastasis group,and 70 postoperative gastric cancer patients without recurrence or metastasis confirmed by clinicopathologic examination were enrolled as non-recurrence metastasis group.All patients underwent ^(18)F-FDG PET/CT examination and were tested for serum CA19-9 and CA72-4.The diagnostic val-ue of ^(18)F-FDG PET/CT,CA19-9 and CA72-4 for recurrence and metastasis was evaluated by receiver operating character-istic(ROC)curve.Result The area under the curve(AUC)of ^(18)F-FDG PET/CT images in the diagnosis of recurrence and metastasis after gastric cancer surgery was 0.848(95%CI:0.752-0.918),the sensitivity and specificity were 77.78%and 91.89%,respectively.The levels of serum CA19-9 and CA72-4 in recurrence and metastasis group were significantly higher than those in non-recurrence and metastasis group(P<0.01).AUC values of single and combined detection of se-rum CA19-9 and CA72-4 in diagnosing the recurrence and metastasis after gastric cancer surgery were 0.835,0.822 and 0.923,respectively.Conclusion ^(18)F-FDG PET/CT imaging can clearly display recurrence and metastasis after gastric cancer surgery,which has high diagnostic value for the recurrence and metastasis.The combined detection of serum CA19-9 and CA72-4 has high screening value for recurrence and metastasis after gastric cancer surgery.