CAJ | 학술논문

目的：探讨18 F -脱氧葡萄糖（FDG）SPECT/ CT 显像诊断乳腺癌术后复发和（或）转移的价值及与血清糖类抗原 CA15-3、CA125和癌胚抗原（CEA）单独或联合诊断的效能比较。方法：对46例乳腺癌术后患者18 F - FDG SPECT/ CT 显像图像进行分析，计算靶/非靶（T/ N）比值及诊断的灵敏度、特异性、阳性预测值、阴性预测值、准确性，并与患者同期血清 CA15-3、CA125和 CEA 水平联合诊断结果对比。结果：18 F - FDG SPECT/ CT 显像诊断46例乳腺癌术后复发和（或）转移的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为81.82％（18/22）、83.33％（20/24）、81.82％（18/22）、83.33％（20/24）和82.61％（38/46）。血清CA15-3、CA125和 CEA 的联合诊断率分别为50.00％（11/22）、95.83％（23/24）、91.67％（11/12）、67.65％（23/34）和73.91％（34/46）。两种方法联合分别为86.36％（19/22）、100.00％（24/24）、100.00％（19/19）、88.89％（24/27）和93.48％（43/46）。单独18 F - FDG SPECT/ CT 显像和两种方法联合诊断灵敏度均明显高于血清 CA15-3、CA125和 CEA（P ＝0.0260，P ＝0.0096）；两种方法联合诊断特异性明显高于18 F - FDG SPECT/ CT 显像（P ＝0.0367）。18 F - FDG SPECT/ CT 显像示良、恶性病灶间 T/ N 比值差异有统计学意义（5.05±11.22与1.69±0.29，t ＝1.7247，P ＜0.05）。结论：18 F - FDG SPECT/ CT 显像诊断乳腺癌术后复发和（或）转移有较高的临床价值，如能结合血清 CA15-3、CA125和 CEA 诊断特异性更高。
목적：탐토18 F -탈양포도당（FDG）SPECT/ CT 현상진단유선암술후복발화（혹）전이적개치급여혈청당류항원 CA15-3、CA125화암배항원（CEA）단독혹연합진단적효능비교。방법：대46례유선암술후환자18 F - FDG SPECT/ CT 현상도상진행분석，계산파/비파（T/ N）비치급진단적령민도、특이성、양성예측치、음성예측치、준학성，병여환자동기혈청 CA15-3、CA125화 CEA 수평연합진단결과대비。결과：18 F - FDG SPECT/ CT 현상진단46례유선암술후복발화（혹）전이적령민도、특이성、양성예측치、음성예측치화준학성분별위81.82％（18/22）、83.33％（20/24）、81.82％（18/22）、83.33％（20/24）화82.61％（38/46）。혈청CA15-3、CA125화 CEA 적연합진단솔분별위50.00％（11/22）、95.83％（23/24）、91.67％（11/12）、67.65％（23/34）화73.91％（34/46）。량충방법연합분별위86.36％（19/22）、100.00％（24/24）、100.00％（19/19）、88.89％（24/27）화93.48％（43/46）。단독18 F - FDG SPECT/ CT 현상화량충방법연합진단령민도균명현고우혈청 CA15-3、CA125화 CEA（P ＝0.0260，P ＝0.0096）；량충방법연합진단특이성명현고우18 F - FDG SPECT/ CT 현상（P ＝0.0367）。18 F - FDG SPECT/ CT 현상시량、악성병조간 T/ N 비치차이유통계학의의（5.05±11.22여1.69±0.29，t ＝1.7247，P ＜0.05）。결론：18 F - FDG SPECT/ CT 현상진단유선암술후복발화（혹）전이유교고적림상개치，여능결합혈청 CA15-3、CA125화 CEA 진단특이성경고。
Objective:To evaluate the value of 18 F - fluorodeoxyglucose(FDG)SPECT/ CT imaging alone or com-bined serum carbohydrate antigen(CA)15 - 3,CA125 and carcinoembryonic antigen(CEA)in detecting recurrence and(or)metastases in breast cancer patient after surgery. Methods:18 F - FDG SPECT/ CT imaging was performed in 46 patients with breast cancer after surgery. Results of FDG SPECT/ CT images were compared with serum tumor marker(CA15 - 3,CA125 and CEA)during the corresponding period(two weeks before or after 18 F - FDG SPECT/CT imaging). Results:Of the 46 patients,22(47. 83% )had metastases,confirmed or endorsed by post - operation pathology,and(or)clinical follow - up(more than six months). The sensitivity,specificity,positive predictive value (PPV),negative predictive value(NPV),and accuracy of 18 F - FDG SPECT/ CT imaging were 81. 82%(18 / 22),83. 33%(20 / 24),81. 82%(18 / 22),83. 33%(20 / 24)and 82. 61%(38 / 46).Those of serum tumor marker(CA15 -3,CA125 and CEA)were 50. 00%(11 / 22),95. 83%(23 / 24),91. 67%(11 / 12),67. 65%(23 / 34)and 73. 91%(34 / 46). And those of 18 F - FDG SPECT/ CT imaging combined serum tumor marker(CA15 - 3,CA125 and CEA) were 86. 36%(19 / 22),100. 00%(24 / 24),100. 00%(19 / 19),88. 89%(24 / 27)and 93. 48%(43 / 46)respective-ly. The sensitivity of 18 F - FDG SPECT/ CT imaging and 18 F - FDG SPECT/ CT imaging combined serum tumor marker were higher than serum tumor marker alone(P = 0. 026 0;P = 0. 009 6). The specificity of 18 F - FDG SPECT/ CT im-aging combined serum tumor marker was higher than 18 F - FDG SPECT/ CT imaging alone(P = 0. 036 7). The taget/non - taget(T/ NT)values of 18 F - FDG SPECT/ CT imaging in detecting malignant and benign lesions were 5. 05 ± 11. 22 vs 1. 69 ± 0. 29(t = 1. 724 7,P < 0. 05). Conclusion:18 F - FDG SPECT/ CT imaging has the highest sensitivi-ty in detecting metastases breast cancer,and combined with serum tumor marker(CA15 - 3,CA125 and CEA)would improve its specificity.