Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-Ku, Kyoto 606-8507, Japan.
Ann Nucl Med. 2010 Jul;24(6):433-9. doi: 10.1007/s12149-010-0387-5. Epub 2010 Jun 11.
The purpose of this study was to evaluate the prevalence of positive findings of positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) in patients with high serum CEA levels.
A total of 303 patients who had undergone an FDG-PET scan in our institution with high serum CEA levels were analyzed. The prevalence of positive PET findings was evaluated with regard to a previous history of malignancy, absolute value of CEA levels, and the time course of CEA levels (an increasing or decreasing pattern, a change divided by time (DeltaCEA) and doubling time of CEA).
Of 303 patients, 232 were confirmed to have malignancy, and the patient-based sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of PET were 87, 86, 95, 66, and 86%, respectively. There was no statistically significant difference in positive rates according to the history of previous malignancy. The prevalence of PET-positive cases was higher with an increase in absolute CEA levels, and more than 90% of the patients were positive when CEA levels were more than 20 ng/ml. The DeltaCEA was significantly higher and the doubling time was significantly shorter in patients with positive results than those with negative results.
A high value of serum CEA levels was correlated with a higher prevalence of positive PET findings. FDG-PET scans would be justified in patients with high serum CEA levels, regardless of whether there was or was not a previous history of malignancy.
本研究旨在评估血清癌胚抗原（CEA）水平升高的患者中，正电子发射断层扫描（PET）用 2-脱氧-2-[18F]氟代-D-葡萄糖（FDG）检查阳性结果的发生率。
对在我院进行 FDG-PET 扫描且血清 CEA 水平升高的 303 例患者进行分析。根据恶性肿瘤既往史、CEA 绝对值和 CEA 水平变化时间（递增或递减模式、变化值与时间之比（DeltaCEA）和 CEA 倍增时间）评估 PET 阳性发现的发生率。
303 例患者中，232 例经证实患有恶性肿瘤，以患者为基础，PET 的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 87%、86%、95%、66%和 86%。根据恶性肿瘤既往史，阳性率无统计学差异。随着 CEA 绝对值的增加，PET 阳性病例的发生率较高，当 CEA 水平超过 20ng/ml 时，超过 90%的患者为阳性。阳性结果患者的 DeltaCEA 明显更高，倍增时间明显更短。
血清 CEA 水平升高与 PET 阳性发现的发生率较高相关。无论是否有恶性肿瘤既往史，对于血清 CEA 水平升高的患者，进行 FDG-PET 扫描是合理的。
