18 F-FDG PET/CT在宫颈鳞癌治疗后鳞状细胞癌抗原升高患者中的应用价值

摘要： 目的 探讨18 F-FDG PET/CT在宫颈鳞状细胞癌治疗后血清鳞状细胞癌抗原 （SCC-Ag） 升高患者中的应用价值。方法 回顾性分析52例宫颈鳞癌手术和 （或） 放、 化疗后血清SCC-Ag升高 （＞1.5 μg/L） 患者， 18 F-FDG PET/CT 全身扫描查找有无复发和 （或） 转移灶。以病理学和 （或） 随诊结果为诊断标准， 评价PET/CT对宫颈鳞癌复发和 （或）转移的诊断效能。随访时间6~12个月。结果 PET/CT发现异常代谢增高灶者44例， 阴性表现者8例。42例患者经组织病理或临床随诊证实复发和 （或） 转移， PET/CT诊断宫颈鳞癌术后复发和 （或） 转移假阳性3例、 假阴性1例， PET/ CT诊断宫颈鳞癌复发和 （或） 转移的敏感度为97.6% （41/42）， 特异度为70.0% （7/10）， 阳性预测值为93.2% （41/44）， 阴性预测值为87.5% （7/8）， 准确度为92.3% （48/52）。PET/CT显像诊断结果与组织病理 （和） 或临床随诊结果具有高度一致性 （Kappa值=0.732）。结论 18 F-FDG PET/CT是宫颈鳞癌治疗后SCC-Ag升高患者复发和 （或） 转移的有效诊断方法， 具有重要的临床应用价值。

Clinical usefulness of 18 F-FDG PET/CT in patients with elevated SCC antigen after treatment of uterine cervix squamous cell cancer

Abstract: Objective To investigate the diagnostic value of 18 F - fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) in uterine cervix squamous cell cancer patients with squamous cell carcinoma antigen （SCC-Ag） elevation after treatment. Methods Data of 52 cervical squamous cancer patients with elevated SCC-Ag (>1.5 μg/L) after surgery and/or radiotherapy and chemotherapy were retrospectively analyzed．18 F-FDG PET/CT was used for full body scanning to show the recurrence and / or metastasis in patients. The diagnostic efficiency of PET / CT in the recurrence and/or metastasis of cervical squamous cell carcinoma was evaluated according to pathological and (or) follow-up results. The follow-up period was 6 to 12 months. Results There were positive 18 F-FDG PET/CT findings in 44 patients and negative 18 F-FDG PET/CT findings in 8 patients. There were 3 false-positive and 1 false-negative cases. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnostic efficiency of PET/CT were 97.6% (41/42), 70.0% (7/10)， 93.2% (41/44)， 87.5%(7/8) and 92.3%(48/52) respectively. The diagnostic results of 18 F-FDG PET/CT are highly consistent with histopathological and (or) clinical follow-up results (Kappa value=0.732，P＜0.01). Conclusion 18 F-FDG PET /CT can reliably identify and accurately detect the recurrence and (or) metastasis of cervical squamous cancer in patients with elevated SCC-Ag after treatment, which has important clinical application value.