18F-脱氧葡萄糖PET/CT联合胰腺肿瘤标志物在诊断早期可切除胰腺癌术后复发转移中的应用价值

Value of 18F-fluorodeoxyglucose PET/CT combined with pancreatic tumor markers in the diagnosis of recurrence and metastasis after surgery for early resectable pancreatic cancer

摘要:

目的：探讨18F-脱氧葡萄糖（18F-fluorodeoxyglucose，18F-FDG）正电子发射型计算机断层显像（positron emission computed tomography，PET/CT）联合常见血清胰腺肿瘤标志物在诊断早期可切除胰腺癌术后复发转移中的价值及相关性。方法：回顾性分析53例早期可切除胰腺癌患者术后怀疑复发转移而行PET/CT和胰腺肿瘤标志物检测的相关检查资料，探究两者联合检查用于诊断早期可切除胰腺癌术后复发转移的价值及相关性。结果：联合组[PET/CT+糖类抗原19-9（carbohydrate antigen 19-9，CA19-9）+糖类抗原242（carbohydrate antigen 242，CA242）+糖类抗原50（carbohydrate antigen 50，CA50）]在诊断早期可切除胰腺癌术后复发转移的灵敏度、特异度、准确率、阳性预测值（positive predictive value，PPV）及阴性预测值（negative predictive value，NPV）分别为 97.83%、85.71%、96.23%、97.83%、85.71%。其中联合组灵敏度分别高于单独CA19-9组、单独CA242组、单独CA50组，差异均具有统计学意义（P＜0.05）。联合组准确率分别高于单独PET/CT组、单独CA19-9组、单独CA242组、单独CA50组，差异均具有统计学意义（P＜0.05）。血清CA19-9水平与PET/CT中病灶的最大标准化摄取值（maximum standardized uptake value，SUVmax）呈正相关（r=0.583，P=0.018）。结论：18F-FDG PET/CT检查联合常见胰腺肿瘤标志物检测在诊断早期可切除胰腺癌术后复发转移中具有较高的灵敏度、准确率及阳性预测值，能尽早诊断胰腺癌术后出现的复发转移，使患者及时得到进一步治疗。

Abstract:

Objective：To investigate the value of 18F-fluorodeoxyglucose（18F-FDG） PET/CT combined with common serum pancreatic tumor markers in the diagnosis of recurrence and metastasis after surgery for early resectable pancreatic cancer. Methods：A retro－spective analysis was performed for the clinical data of 53 patients who were suspected of recurrence and metastasis after surgery for early resectable pancreatic cancer and underwent PET/CT，in order to explore the value of PET/CT combined with pancreatic tumor markers in the diagnosis of recurrence and metastasis after surgery for early resectable pancreatic cancer. Results：The combination group[PET/CT+carbohydrate antigen 19-9（CA19-9）+carbohydrate antigen 242（CA242）+carbohydrate antigen 50（CA50）] had a sen－sitivity of 97.83%，a specificity of 85.71%，an accuracy of 96.23%，a positive predictive value of 97.83%，and a negative predictive value of 85.71% in the diagnosis of recurrence and metastasis after surgery for early resectable pancreatic cancer. The combination group had a significantly higher sensitivity than the CA19-9 group，the CA242 group，and the CA50 group（P<0.05）. The combination group had significantly higher accuracy than the PET/CT group，the CA19-9 group，the CA242 group，and the CA50 group（P<0.05）. Serum CA19-9 level was positively correlated with maximum standardized uptake value of PET/CT（r=0.583，P=0.018）. Conclusion：18F-FDG PET/CT combined with common serum pancreatic tumor markers has high sensitivity，accuracy，and positive predictive value in the diagnosis of recurrence and metastasis after surgery for early resectable pancreatic cancer. It can identify recurrence and metastasis after pancreatic cancer surgery as early as possible to help patients get timely treatment.