Wang Qian, Hong Lian, Wang Jian-liu, Yue Ming-gang, Li He-bei, Li Yuan
Department of Nuclear Medicine, Peking University People's Hospital, Beijing 100044, China.
Zhonghua Zhong Liu Za Zhi. 2010 Apr;32(4):300-3.
Both (18)F-fluorodeoxyglucose (FDG) imaging and serum tumor marker measurements can be used in the post-therapy surveillance of recurrent endometrial carcinoma, but the relationship between those two methods has not been demonstrated yet. The purpose of this study was to compare the diagnostic efficiency of (18)F-FDG imaging and serum tumor marker measurements in the diagnosis of recurrent endometrial carcinoma, as well as to analyze the correlation between those two methods.
Thirty-five patients with histopathologically confirmed endometrial carcinoma and suspected to have recurrent disease during post-therapy surveillance were included in this study. (18)F-FDG images from the thorax to the pelvis were obtained in all patients by using GE-Millennium VG Hawkeye system, and the abnormal FDG uptake was judged as tumor recurrence. Serum CA-125 and CP-2 were also measured for each patient by enzyme-linked immunoassay, and a cutoff value of 35 U/ml was taken as the criteria for predicting tumor recurrence. Based on the final clinical diagnosis, the efficiency of tumor markers (CA-125, CP-2) and (18)F-FDG imaging in the diagnosis of recurrent tumor was evaluated.
According to the histopathological diagnosis or follow-up examinations, tumor recurrence was confirmed in 13 of the 35 patients. Elevated serum level of CA-125 was found in 7 patients, serum CP-2 was increased in 9, and (18)F-FDG imaging was positive in 15. The diagnostic sensitivity, specificity and accuracy were 53.8%, 100% and 82.9% for the serum CA-125; 38.5%, 81.0% and 65.7% for the serum CP-2, and 100%, 90.9% and 94.3% for the (18)F-FDG imaging, respectively. The diagnostic coincidence rate between the (18)F-FDG imaging and serum CA-125 was 77.1% (Kappa = 0.50, P = 0.001), but no significant correlation was found between the (18)F-FDG imaging and serum CP-2. In the patients with true positive (18)F-FDG imaging, a positive correlation between the tumor volume and the serum CA-125 value was found (r = 0.89, P < 0.001), but no correlation was found between the tumor uptake and the serum CA-125 values.
For the post-therapy surveillance of patients with endometrial carcinoma, serum CA-125 is a high specific tumor marker for diagnosing recurrent disease and better than CP-2, but (18)F-FDG imaging is better than CA-125, and there is a positive correlation between tumor volume and serum CA-125 value.
（18）F - 氟脱氧葡萄糖（FDG）成像和血清肿瘤标志物检测均可用于复发性子宫内膜癌的治疗后监测，但这两种方法之间的关系尚未得到证实。本研究的目的是比较（18）F - FDG成像和血清肿瘤标志物检测在复发性子宫内膜癌诊断中的诊断效率，并分析这两种方法之间的相关性。
本研究纳入了35例经组织病理学确诊为子宫内膜癌且在治疗后监测期间疑似复发的患者。所有患者均使用GE - Millennium VG Hawkeye系统获取从胸部到骨盆的（18）F - FDG图像，FDG摄取异常被判定为肿瘤复发。还通过酶联免疫吸附测定法对每位患者的血清CA - 125和CP - 2进行了检测，并将35 U/ml的临界值作为预测肿瘤复发的标准。根据最终临床诊断，评估肿瘤标志物（CA - 125、CP - 2）和（18）F - FDG成像在复发性肿瘤诊断中的效率。
根据组织病理学诊断或随访检查，35例患者中有13例确诊为肿瘤复发。7例患者血清CA - 125水平升高，9例血清CP - 2升高，15例（18）F - FDG成像呈阳性。血清CA - 125的诊断敏感性、特异性和准确性分别为53.8%、100%和82.9%；血清CP - 2分别为38.5%、81.0%和65.7%；（18）F - FDG成像分别为100%、90.9%和94.3%。（18）F - FDG成像与血清CA - 125之间的诊断符合率为77.1%（Kappa = 0.50，P = 0.001），但（18）F - FDG成像与血清CP - 2之间未发现显著相关性。在（18）F - FDG成像真阳性的患者中，发现肿瘤体积与血清CA - 125值之间存在正相关（r = 0.89，P < 0.001），但肿瘤摄取与血清CA - 125值之间未发现相关性。
对于子宫内膜癌患者的治疗后监测，血清CA - 125是诊断复发性疾病的高特异性肿瘤标志物，优于CP - 2，但（18）F - FDG成像优于CA - 125，且肿瘤体积与血清CA - 125值之间存在正相关。
