Zhang Tie-mei, Zhang Lian-min, Liu Yang, Zhang Zhen-fa, Wang Chang-li
Department of Lung Cancer, Tianjin Medical University, Tianjin, China.
Zhonghua Yi Xue Za Zhi. 2012 Nov 6;92(41):2901-4.
To evaluate the diagnostic value of (18)F-FDG positron emission tomography/computed tomography (PET/CT) plus serum tumor marker assay in lung cancer and explore the correlation between standard uptake value (SUVmax) with clinicopathologic factors in lung cancer.
A total of 177 cases of lung cancer diagnosed by radiography or computed tomography (CT) were recruited.(18)F-FDG PET/CT imaging and detection of three lung cancer related serum markers (carcinoembryonic antigen, CYFRA21-1 and neuron specific enolase) were performed within one week in all cases. The sensitivity, specificity and accuracy of those approaches were calculated through comparing the results with pathologic examinations. Also the associations between SUVmax and clinicopathologic features were analyzed.
Among them, 145 patients were detected to have lung cancer by pathologic diagnosis while the other 32 patients had benign lung diseases. The sensitivity, specificity, accuracy of (18)F-FDG PET/CT imaging, serum tumor markers and their combination in assessing lung cancers were 89.7%, 78.1%, 87.6%; 89.7%, 78.1%, 87.6% and 96.6%, 56.3%, 89.3% respectively. The combination of (18)F-FDG PET/CT and serum tumor markers in lung lesions showed significantly higher sensitivity than serum tumor markers and (18)F-FDG PET/CT alone (P = 0.000, P = 0.002). Its accuracy was also significantly higher than those of tumor markers (P < 0.05). Compared with (18)F-FDG PET/CT alone, the accuracy was higher in combination group. But the difference showed no statistical significance (P > 0.05). SUVmax was significantly associated with tumor staging, tumor size and pathologic type.
The combination of (18)F-FDG PET/CT and tumor markers may improve the positive diagnostic rate of lung cancer. And SUVmax can help to evaluate tumor staging and determine pathological types.
评估¹⁸F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）联合血清肿瘤标志物检测在肺癌诊断中的价值，并探讨肺癌标准摄取值（SUVmax）与临床病理因素之间的相关性。
纳入177例经X线摄影或计算机断层扫描（CT）诊断为肺癌的患者。所有患者均在1周内进行¹⁸F-FDG PET/CT成像及三种肺癌相关血清标志物（癌胚抗原、细胞角蛋白19片段抗原21-1和神经元特异性烯醇化酶）检测。将检测结果与病理检查结果进行比较，计算上述方法的灵敏度、特异度和准确度。同时分析SUVmax与临床病理特征之间的相关性。
其中145例经病理诊断为肺癌，32例为良性肺部疾病。¹⁸F-FDG PET/CT成像、血清肿瘤标志物及其联合检测在评估肺癌中的灵敏度、特异度、准确度分别为89.7%、78.1%、87.6%；89.7%、78.1%、87.6%和96.6%、56.3%、89.3%。¹⁸F-FDG PET/CT与血清肿瘤标志物联合检测对肺部病变的灵敏度显著高于单独血清肿瘤标志物及¹⁸F-FDG PET/CT（P = 0.000，P = 0.002）。其准确度也显著高于肿瘤标志物（P < 0.05）。与单独¹⁸F-FDG PET/CT相比，联合组准确度更高，但差异无统计学意义（P > 0.05）。SUVmax与肿瘤分期、肿瘤大小及病理类型显著相关。
¹⁸F-FDG PET/CT与肿瘤标志物联合检测可提高肺癌的阳性诊断率。且SUVmax有助于评估肿瘤分期及确定病理类型。
