血清肿瘤标志物CA125及~(18)F-FDG PET/CT造影在卵巢癌复发早期诊断中的价值
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摘要
目的探讨血清肿瘤标志物CA125、~(18)F-FDG PET/CT及两者联合检测在卵巢癌复发早期诊断中的价值。方法 2016年3月至2017年6月,对41例疑似复发的卵巢癌术后患者行~(18)F-FDG PET/CT造影和血清CA125检测,随访复发转移灶,并以病理检查结果为金标准计算灵敏度、特异度、诊断符合率、阳性预测值和阴性预测值。结果根据病理结果诊断为卵巢癌复发、转移的共36例。CA125对卵巢癌复发、转移诊断的灵敏度、特异度、诊断符合率、阳性预测值和阴性预测值分别为91.7%(33/36)、80.0%(4/5)、90.2%(37/41)、97.1%(33/34)、57.1%(4/7);~(18)F-FDG PET/CT对卵巢癌复发、转移诊断的灵敏度、特异度、诊断符合率、阳性预测值和阴性预测值分别为97.2%(35/36)、80.0%(4/5)、95.1%(39/41)、97.2%(35/36)、80.0%(4/5);两者联合检测对卵巢癌复发、转移诊断的灵敏度、特异度、诊断符合率、阳性预测值和阴性预测值分别为100.0%(36/36)、80.0%(4/5)、97.6%(40/41)、97.3%(36/37)、100.0%(4/4)。~(18)F-FDG PET/CT对卵巢癌复发、转移诊断的灵敏度、诊断符合率和阴性预测值均高于CA125;两者联合检测的灵敏度和阴性预测值均高于CA125和~(18)F-FDG PET/CT单独检测。结论血清肿瘤标志物CA125联合~(18)F-FDG PET/CT检测卵巢癌复发情况的效果良好,值得临床应用。
Objective To investigate the value of serum tumor markers CA125,~(18)F-FDG PET/CT and their combined detection in early diagnosis of ovarian cancer recurrence. Methods From March 2016 to June 2017, 41 patients with suspected recurrent ovarian cancer were given~(18)F-FDG PET/CT imaging and serum CA125 detection, and recurrence metastasis were followed up. The pathological examination result was used as the gold standard to calculate sensitivity,specificity, diagnostic coincidence rate, positive predictive value and negative predictive value. Results Thirty-six cases of ovarian cancer recurrence and metastasis were diagnosed according to pathological findings. The sensitivity, specificity,diagnostic coincidence rate, positive predictive value and negative predictive value of CA125 in diagnosis of ovarian cancer recurrence and metastasis were 91.7%(33/36), 80.0%(4/5), 90.2%(37/41), 97.1%(33/34) and 57.1%(4/7), respectively.The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and negative predictive value of~(18)F-FDG PET/CT in diagnosis of ovarian cancer recurrence and metastasis were 97.2%(35/36), 80.0%(4/5), 95.1%(39/41), 97.2%(35/36) and 80.0%(4/5), respectively. The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and negative predictive value of combined detection were 100.0%(36/36), 80.0%(4/5), 97.6%(40/41), 97.3%(36/37) and100.0%(4/4), respectively. The sensitivity, diagnostic coincidence rate and negative predictive value of~(18)F-FDG PET/CT in diagnosis of ovarian cancer recurrence and metastasis were higher than those of CA125. The sensitivity and negative predictive value of combined detection were higher than those of CA125 and~(18)F-FDG PET/CT alone. Conclusion Serum tumor markers CA125 combined with~(18)F-FDG PET/CT has a good effect in detecting the recurrence of ovarian cancer,which is worthy of clinical application.
Objective To investigate the value of serum tumor markers CA125,~(18)F-FDG PET/CT and their combined detection in early diagnosis of ovarian cancer recurrence. Methods From March 2016 to June 2017, 41 patients with suspected recurrent ovarian cancer were given~(18)F-FDG PET/CT imaging and serum CA125 detection, and recurrence metastasis were followed up. The pathological examination result was used as the gold standard to calculate sensitivity,specificity, diagnostic coincidence rate, positive predictive value and negative predictive value. Results Thirty-six cases of ovarian cancer recurrence and metastasis were diagnosed according to pathological findings. The sensitivity, specificity,diagnostic coincidence rate, positive predictive value and negative predictive value of CA125 in diagnosis of ovarian cancer recurrence and metastasis were 91.7%(33/36), 80.0%(4/5), 90.2%(37/41), 97.1%(33/34) and 57.1%(4/7), respectively.The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and negative predictive value of~(18)F-FDG PET/CT in diagnosis of ovarian cancer recurrence and metastasis were 97.2%(35/36), 80.0%(4/5), 95.1%(39/41), 97.2%(35/36) and 80.0%(4/5), respectively. The sensitivity, specificity, diagnostic coincidence rate, positive predictive value and negative predictive value of combined detection were 100.0%(36/36), 80.0%(4/5), 97.6%(40/41), 97.3%(36/37) and100.0%(4/4), respectively. The sensitivity, diagnostic coincidence rate and negative predictive value of~(18)F-FDG PET/CT in diagnosis of ovarian cancer recurrence and metastasis were higher than those of CA125. The sensitivity and negative predictive value of combined detection were higher than those of CA125 and~(18)F-FDG PET/CT alone. Conclusion Serum tumor markers CA125 combined with~(18)F-FDG PET/CT has a good effect in detecting the recurrence of ovarian cancer,which is worthy of clinical application.
引文
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[12]陈璐,孙敬,陈琛.人附睾蛋白在卵巢癌诊断中的应用[J].医学研究生学报,2013,26(8):836-838.
[13]陈燕,林莺莺,郑瑜宏,等.血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价[J].中国免疫学杂志,2013,29(2):168-174.
[14]杨丽萍,李会影,任淑敏.血清HE4联合CA125检测在卵巢癌诊断、治疗中的价值[J].中国老年学杂志,2014,34(24):7083-7084.
[15]唐丽媛,谢力,王晓囡,等.血清HE4、CA125和CA19-9检测在卵巢肿瘤诊断中的临床意义[J].中国妇幼保健,2015,30(15):2352-2353.
[16]潘秀芳,郑志昂,麦燕.血清附睾蛋白4、糖类抗原125及19-9水平在老年卵巢癌诊断及病理类型鉴别中的临床价值[J].中国老年学杂志,2015,35(12):3343-3344.
[17]宁力,邹丹丹,陈燕妹.不同临床分期的卵巢癌患者血清HE4、CA125、CA19-9阳性率的比较[J].中国妇幼保健,2015,30(17):2709-2711.
[18]陈忠,强福林,夏淦林,等.卵巢癌术后血清CA125检测与PET-CT检查结果对比分析[J].肿瘤基础与临床,2014,27(5):410-412.
[2]丁小东.血清CA125检测联合PET CT显像对早期卵巢癌诊断的应用研究[J].中医学报,2014,29(B7):127.
[3]邓智勇,周友俊,孙华,等.18F-FDG PET/CT显像在卵巢癌术后随访中的价值及与血清CA125检测的关系[J].中国临床医学影像杂志,2012,23(1):17-20.
[4]李敏,李绪清,颜士杰,等.18F-脱氧葡萄糖PET/CT联合CA125在诊断卵巢癌复发转移中的应用价值[J].重庆医科大学学报,2017,42(12):1635-1638.
[5]赵卫威,李艳梅,李鹏,等.血清糖类抗原125水平与18F-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[J].肿瘤影像学,2016,25(1):45-49.
[6]朱辉,李智勇.PET/CT联合CEA、CA125、CYFRA21-1检测在鉴别诊断晚期肺癌的应用研究[J].广西医科大学学报,2016,33(3):495-497.
[7]覃春霞,韩娜,张永学,等.卵巢混合性生殖细胞瘤18F-FDG PET/CT影像诊断思路探讨[J].中华核医学与分子影像杂志,2017,37(4):234-236.
[8]龚静,刘陶,王雅琴,等.CEA及CA125检测与PET/CT显像在诊断卵巢癌中的价值[J].实用妇产科杂志,2016,32(12):946-947.
[9]沈小东,潘建虎.18F-FDG PET/CT显像探测卵巢癌术后复发及转移的临床有效性及可行性评价[J].重庆医学,2015,44(18):2567-2569.
[10]张倩,辛军,曹礼等.影像表现与病理对照分析[J].中华核医学与分子影像杂志,2017,37(8):460-463.
[11]卓小丽,李诗运,戴儒奇,等.18F-FDG PET/CT显像与血清CA125水平的关系及在老年卵巢癌早期诊断、分期及术后随访中的价值[J].中国老年学杂志,2017,37(20):5070-5072.
[12]陈璐,孙敬,陈琛.人附睾蛋白在卵巢癌诊断中的应用[J].医学研究生学报,2013,26(8):836-838.
[13]陈燕,林莺莺,郑瑜宏,等.血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价[J].中国免疫学杂志,2013,29(2):168-174.
[14]杨丽萍,李会影,任淑敏.血清HE4联合CA125检测在卵巢癌诊断、治疗中的价值[J].中国老年学杂志,2014,34(24):7083-7084.
[15]唐丽媛,谢力,王晓囡,等.血清HE4、CA125和CA19-9检测在卵巢肿瘤诊断中的临床意义[J].中国妇幼保健,2015,30(15):2352-2353.
[16]潘秀芳,郑志昂,麦燕.血清附睾蛋白4、糖类抗原125及19-9水平在老年卵巢癌诊断及病理类型鉴别中的临床价值[J].中国老年学杂志,2015,35(12):3343-3344.
[17]宁力,邹丹丹,陈燕妹.不同临床分期的卵巢癌患者血清HE4、CA125、CA19-9阳性率的比较[J].中国妇幼保健,2015,30(17):2709-2711.
[18]陈忠,强福林,夏淦林,等.卵巢癌术后血清CA125检测与PET-CT检查结果对比分析[J].肿瘤基础与临床,2014,27(5):410-412.