Zhang Yan, Feng Bin, Zhang Guo-Li, Hu Man, Fu Zheng, Zhao Fen, Zhang Xiao-Li, Kong Li, Yu Jin-Ming
Yan Zhang, Jin-Ming Yu, Graduate school of Tianjin Medical University, Tianjin 300070, China.
World J Gastroenterol. 2014 Jun 7;20(21):6608-14. doi: 10.3748/wjg.v20.i21.6608.
To evaluate the value of positron emission tomography (PET)/computerized tomography (CT) in surveillance of colorectal cancer (CRC) patients with different carcinoembryonic antigen (CEA) concentrations.
One hundred and six postoperative CRC patients who had suspected recurrence or metastasis and received fluorodeoxyglucose (FDG) PET/CT within one week were included in this study. The final diagnosis was confirmed by histological examination or clinical follow-up over at least six months.
The sensitivity, specificity, and accuracy of FDG PET/CT were 95.2%, 82.6%, and 92.5%, and 94.8%, 81.4% and 92.8%, respectively, in the case- and lesion-based analyses. The sensitivity and accuracy of FDG PET/CT significantly differed from CT in both analyses (χ(2) = 8.186, P = 0.004; χ(2) =6.201, P = 0.013; χ(2) =13.445, P = 0.000; χ(2) =11.194, P = 0.001). In the lesion-based analysis, the sensitivity, specificity, and accuracy of FDG PET/CT in the abnormal CEA group were 97.8%, 82.6%, and 95.6%, compared with 81.3%, 80%, and 80.6% for patients with normal CEA levels. In case-based analysis, the sensitivity, specificity, and accuracy of FDG PET/CT were 97.2%, 77.8%, and 95% in abnormal CEA group. Only in lesion-based analysis, the sensitivity and accuracy of FDG PET/CT in the abnormal CEA group were significantly superior to those in the normal CEA group (χ(2) =6.432, P = 0.011; χ(2) =7.837, P = 0.005). FDG PET/CT changed the management in 45.8% of patients with positive scans.
FDG PET/CT showed superior diagnostic value and is an advisable option in surveillance of postoperative CRC patients with a vague diagnosis.
评估正电子发射断层扫描（PET）/计算机断层扫描（CT）在监测不同癌胚抗原（CEA）浓度的结直肠癌（CRC）患者中的价值。
本研究纳入106例术后CRC患者，这些患者怀疑复发或转移，并在一周内接受了氟脱氧葡萄糖（FDG）PET/CT检查。最终诊断通过组织学检查或至少6个月的临床随访得以证实。
在基于病例和基于病灶的分析中，FDG PET/CT的敏感性、特异性和准确性分别为95.2%、82.6%和92.5%，以及94.8%、81.4%和92.8%。在两种分析中，FDG PET/CT的敏感性和准确性与CT相比均有显著差异（χ(2)=8.186，P = 0.004；χ(2)=6.201，P = 0.013；χ(2)=13.445，P = 0.000；χ(2)=11.194，P = 0.001）。在基于病灶的分析中，CEA异常组FDG PET/CT的敏感性、特异性和准确性分别为97.8%、82.6%和95.6%，而CEA水平正常的患者分别为81.3%、80%和80.6%。在基于病例的分析中，CEA异常组FDG PET/CT的敏感性、特异性和准确性分别为97.2%、77.8%和95%。仅在基于病灶的分析中，CEA异常组FDG PET/CT的敏感性和准确性显著高于CEA正常组（χ(2)=6.432，P = 0.011；χ(2)=7.837，P = 0.005）。FDG PET/CT改变了45.8%扫描阳性患者的治疗方案。
FDG PET/CT显示出更高的诊断价值，是监测诊断不明确的术后CRC患者的明智选择。
