血清糖类抗原125水平与^(18)F-脱氧葡萄糖PET/CT诊断卵巢癌复发和转移效能的相关性分析

Correlation analysis between serum carbohydrate antigen 125 level and ^(18)F-fluorodeoxyglucose PET/CT in detecting recurrence and metastasis of ovarian cancer

目的:针对临床怀疑卵巢癌术后复发和转移的患者,比较糖类抗原125(carbohydrate antigen 125,CA125)及^(18)F-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)PET/CT探测卵巢癌复发及转移的效能,探讨两者关系,以发现最优化的检测手段。方法:157例卵巢癌术后临床怀疑复发或转移的患者均进行CA125及PET/CT检查,两者时间间隔少于7 d。结果:PET/CT显像阳性97例,阴性60例,两组的CA125值分别为(188.61±202.70)U/m L、(32.49±67.61)U/m L,差异有统计学意义(P<0.001)。根据国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)卵巢癌分期,Ⅱ期患者16例、Ⅲ期33例、Ⅳ期48例,CA125分别为(155.73±174.23)U/m L、(181.01±211.70)U/m L、(204.80±207.48)U/m L,最大标准摄取值(maximum standardized uptake value,SUVmax)分别为8.45±4.18、8.79±3.55、9.32±4.33,3组之间CA125和SUVmax差异无统计学意义。CA125与SUVmax之间存在低度相关(r=0.203,P=0.046)。CA125预测PET/CT显像阳性的受试者工作特征(receiver operating characteristic,ROC)曲线的最佳切点值为19.07 U/m L,最大曲线下面积为0.871(0.810~0.931),灵敏度为89.7%,特异度为81.7%,阳性预测值为86.1%,阴性预测值为85.7%。结论:血清CA125与PET/CT显像检测卵巢癌复发和转移有较好的一致性,特别是对CA125≥19.07 U/m L的卵巢癌术后患者,PET/CT尤为适用。

Objective: For the clinical suspicion of recurrence and metastasis of ovarian cancer, the diagnostic efficacies of serum carbohydrate antigen 125(CA125) and ^(18)F-fluorodeoxyglucose(^(18)F-FDG) PET/CT were compared and their relationship was analyzed. Methods: ^(18)F-FDG PET/CT and serum CA125 assay were performed in 157 postoperative patient with ovarian cancer, and the time interval was less than 7 d. Results: PET/CT imaging detected 97 positive and 60 negative. The levels of CA125 were(188.61±202.70) U/m L and(32.49±67.61) U/m L in the positive group and negative group, respectively. There was significant difference(P<0.001). According to International Federation of Gynecology and Obstetrics(FIGO) staging of ovarian cancer, 16 were stage Ⅱ, 33 stage Ⅲ and 48 stage Ⅳ. The levels of CA125 were(155.73±174.23) U/m L,(181.01±211.70) U/m L and(204.80±207.48) U/m L, respectively. The corresponding SUVmax values were 8.45±4.18, 8.79±3.55 and 9.32±4.33. There was no significant difference in CA125 level and SUVmax value among three groups. There was a weak correlation between CA125 level and SUVmax value(r=0.203, P=0.046). The receiver operating characteristic(ROC) curve analysis revealed that the optimal cut-off of CA125 level to predict positive ^(18)F-FDG PET/CT result was 19.07 U/m L, the area under curve(AUC) was 0.871(0.810-0.931), the sensitivity was 89.7%, the specificity was 81.7%, the positive predictive value was 86.1%, and the negative predictive value was 85.7%. Conclusion: Serum CA125 and PET/CT imaging in detecting the recurrence and metastasis of ovarian cancer have better consistency. Especially in the ovarian cancer patients with CA125≥19.07 U/m L, PET/CT is particularly applicable.