Gu Xinjin, Liu Rong
Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital and Hainan Branch, Sanya.
Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China.
Clin Interv Aging. 2016 Sep 29;11:1365-1370. doi: 10.2147/CIA.S115254. eCollection 2016.
The current study was designed to analyze the value of 18F-FDG positron emission tomography/computed tomography (PET/CT) combined with carbohydrate antigen 19-9 (CA19-9) in differentiating pancreatic carcinoma (PC) from chronic mass-forming pancreatitis (CMFP) in Chinese elderly.
As it is impossible to differentially diagnose PC from CMFP, 60 participants older than 65 years with focal pancreatic lesions were scanned by 18F-FDG PET/CT and their CA19-9 levels were tested. Diagnoses of all participants were confirmed by comprehensive methods including aspiration biopsy, surgical pathology, and clinical follow-up of 12 months. Twenty participants with CMFP were included in CMFP group and 40 participants with PC in PC group.
In CMFP and PC groups, 46 participants showed increased 18F-FDG uptake, 43 had elevated CA19-9 levels, and 38 participants had both increased 18F-FDG uptake and elevated CA19-9 levels. Standardized uptake value maximum of PC group (5.98±2.27) was significantly different from CMFP group (2.58±1.81, <0.05). Sensitivity, specificity, and accuracy of 18F-FDG PET/CT in differentiating PC from CMFP were 95%, 60%, and 83.3%, respectively. CA19-9 levels of PC group (917.44±1,088.24) were significantly different from CMFP group (19.09±19.54, <0.05). Sensitivity, specificity, and accuracy of CA19-9 levels in differentiating PC from CMFP were 87.5%, 60%, and 78.3%, respectively. Sensitivity, specificity, and accuracy of 18F-FDG PET/CT combined with CA19-9 levels in differentiating PC from CMFP were 90%, 90%, and 90%, respectively.
18F-FDG PET/CT had reliable sensitivity, specificity, and accuracy in differentiating PC from CMFP, and CA19-9 levels could be helpful in 18F-FDG PET/CT for differentiating PC from CMFP in Chinese elderly. Moreover, 18F-FDG PET/CT combined with CA19-9 levels was found to be an effective method to differentially diagnose PC from CMFP and has paved the way for the timely and safe treatment of PC and CMFP in Chinese elderly.
本研究旨在分析18F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）联合糖类抗原19-9（CA19-9）在中国老年人群中鉴别胰腺癌（PC）与慢性肿块型胰腺炎（CMFP）的价值。
由于无法对PC和CMFP进行鉴别诊断，对60例年龄大于65岁的胰腺局灶性病变患者进行18F-FDG PET/CT扫描，并检测其CA19-9水平。所有患者均通过包括穿刺活检、手术病理及12个月的临床随访等综合方法确诊。CMFP组纳入20例CMFP患者，PC组纳入40例PC患者。
在CMFP组和PC组中，46例患者18F-FDG摄取增加，43例CA19-9水平升高，38例患者18F-FDG摄取增加且CA19-9水平升高。PC组的最大标准化摄取值（5.98±2.27）与CMFP组（2.58±1.81，<0.05）有显著差异。18F-FDG PET/CT鉴别PC与CMFP的敏感性、特异性和准确性分别为95%、60%和83.3%。PC组的CA19-9水平（917.44±l088.24）与CMFP组（19.09±19.54，<0.05）有显著差异。CA19-9水平鉴别PC与CMFP的敏感性、特异性和准确性分别为87.5%、60%和78.3%。18F-FDG PET/CT联合CA19-9水平鉴别PC与CMFP的敏感性、特异性和准确性分别为90%、90%和90%。
18F-FDG PET/CT在鉴别PC与CMFP方面具有可靠的敏感性、特异性和准确性，CA19-9水平有助于18F-FDG PET/CT在中国老年人群中鉴别PC与CMFP。此外，18F-FDG PET/CT联合CA19-9水平是鉴别PC与CMFP的有效方法，为中国老年人群中PC和CMFP的及时安全治疗铺平了道路。
