McCartney W H, Hoffer P B
Cancer. 1978 Sep;42(3 Suppl):1457-62. doi: 10.1002/1097-0142(197809)42:3+<1457::aid-cncr2820420814>3.0.co;2-s.
The radionuclide liver scan is a valuable study for detection of hepatic metastases; however, it has a false-negative rate of between 10 and 30%. In a double-blind study involving 377 patients, we assessed the value of CEA assay as an adjunct to liver scanning for detection of hepatic metastases. Fifty-seven patients studied by both methods were ultimately proven to have liver metastases. All patients with CEA levels above 9 ng/ml and focal defects on liver scan had hepatic tumor involvement, while only 4 of 291 patients with CEA values less than 9 ng/ml and negative scans were later shown to have liver metastases. CEA and liver scan results were discordant for 29 patients with proven hepatic metastases: the radionuclide study was positive in 21 cases with false-negative CEA results, while the CEA assay suggested the presence of metastatic disease in eight of the 12 patients with false-negative liver scans.
放射性核素肝脏扫描是检测肝转移瘤的一项重要检查；然而，其假阴性率在10%至30%之间。在一项涉及377例患者的双盲研究中，我们评估了癌胚抗原（CEA）检测作为肝脏扫描辅助手段用于检测肝转移瘤的价值。最终通过两种方法均确诊有肝转移瘤的患者有57例。所有CEA水平高于9 ng/ml且肝脏扫描有局灶性缺损的患者均有肝脏肿瘤累及，而在291例CEA值低于9 ng/ml且扫描结果为阴性的患者中，仅有4例后来被证实有肝转移瘤。对于29例已证实有肝转移瘤的患者，CEA检测结果与肝脏扫描结果不一致：放射性核素检查在21例CEA结果为假阴性的病例中呈阳性，而在12例肝脏扫描结果为假阴性的患者中，有8例的CEA检测提示存在转移性疾病。
