Imaging Diagnosis Teaching and Research Office, Henan Medical College.
Department of Nuclear Medicine, Zhengzhou Central Hospital of Zhengzhou University, Zhengzhou, China.
Nucl Med Commun. 2024 Dec 1;45(12):1061-1068. doi: 10.1097/MNM.0000000000001910. Epub 2024 Oct 4.
Pancreatic cancer is an increasing cause of cancer-related mortality, with persistently low survival rates. We investigated the clinical diagnostic value of the combination of preoperative serum carbohydrate antigen 19-9 (CA19-9), albumin-bilirubin (ALBI) score, and 18 F-fluoro-2-deoxy- d -glucose PET integrated with computed tomography ( 18 F-FDG PET/CT) imaging in pancreatic cancer preoperative resectability.
This study included 143 pancreatic cancer patients, including 68 preoperative resectable and 75 preoperative unresectable pancreatic cancer patients. Meanwhile, 67 patients with non-pancreatic cancer were included as the control group. The clinical data were collected. Serum CA19-9 level was measured by ELISA. The levels of total bilirubin and albumin were determined using a biochemical analyzer, with the ALBI score calculated. All patients underwent 18 F-FDG PET/CT imaging. The consistency of the diagnosis was evaluated by the Kappa test. Logistic univariate and multivariate regression analyses were performed. The diagnostic efficacy of these parameters was evaluated using receiver operating characteristic (ROC) curves, and the optimal ROC curve thresholds were obtained using the Youden index.
The preoperative serum CA19-9 and ALBI score of patients with preoperative resectable pancreatic cancer were increased, which helped diagnose preoperative resectable pancreatic cancer. 18 F-FDG PET/CT imaging had diagnostic value for preoperative resectable pancreatic cancer. Preoperative serum CA19-9, ALBI score, and 18 F-FDG PET/CT imaging were independent influencing factors for pancreatic cancer preoperative resectability, and their combination had higher diagnostic value for preoperative resectable pancreatic cancer than any single of these indexes.
The combination of preoperative serum CA19-9, ALBI score, and 18 F-FDG PET/CT imaging had high diagnostic value for pancreatic cancer preoperative resectability.
胰腺癌是癌症相关死亡率不断上升的原因，其生存率一直很低。我们研究了术前血清糖链抗原 19-9（CA19-9）、白蛋白-胆红素（ALBI）评分与 18 F-氟-2-脱氧-d-葡萄糖正电子发射断层扫描与计算机断层扫描（ 18 F-FDG PET/CT）联合成像在胰腺癌术前可切除性中的临床诊断价值。
本研究纳入 143 例胰腺癌患者，其中 68 例为术前可切除，75 例为术前不可切除。同时，纳入 67 例非胰腺癌患者作为对照组。收集临床资料，采用酶联免疫吸附试验检测血清 CA19-9 水平，采用生化分析仪检测总胆红素和白蛋白水平，计算 ALBI 评分，所有患者均行 18 F-FDG PET/CT 检查。采用 Kappa 检验评价诊断一致性，行单因素和多因素 logistic 回归分析。采用受试者工作特征（ROC）曲线评价各参数的诊断效能，并采用 Youden 指数获得最佳 ROC 曲线阈值。
术前可切除胰腺癌患者的血清 CA19-9 和 ALBI 评分升高，有助于诊断术前可切除胰腺癌。18 F-FDG PET/CT 成像对术前可切除胰腺癌具有诊断价值。术前血清 CA19-9、ALBI 评分和 18 F-FDG PET/CT 成像均为胰腺癌术前可切除性的独立影响因素，三者联合对术前可切除胰腺癌的诊断价值高于任一单项指标。
术前血清 CA19-9、ALBI 评分和 18 F-FDG PET/CT 成像联合对胰腺癌术前可切除性具有较高的诊断价值。
