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目的探讨18F-脱氧葡萄糖(fluorine-18fluorodeoxyglucose,18F-FDG)正电子发射体层摄影术(positron emission tomography/CT,PET/CT)在乳腺癌术后复发转移中的诊断价值及其与糖链抗原(carbohydrate antigen,CA)15-3的关系。方法乳腺癌术后疑诊复发转移患者48例,均行18 F-FDG PET/CT全身显像检查,与组织病理或临床随访结果进行对照,计算18F-FDG PET/CT诊断复发转移的特异性、敏感性;检测48例患者CA15-3水平,并依据检测结果分为增高组(CA15-3≥25μg/L)26例和正常组(CA15-3<25μg/L)22例,比较2组18 F-FDG PET/CT复发转移检出率。结果组织病理或临床随访证实复发转移34例;18F-FDG PET/CT发现阳性病灶35例(其中假阳性2例),未发现异常代谢增高灶13例(其中假阴性1例),诊断乳腺癌术后复发转移的敏感性为97.1%,特异性为85.7%,准确性为93.8%,阳性预测值为94.3%,阴性预测值为92.3%;增高组18F-FDG PET/CT复发转移检出率为76.9%,正常组为59.1%,2组比较差异无统计学意义(P>0.05)。结论 18F-FDG PET/CT在乳腺癌术后复发转移诊断中有重要价值,并适用于CA15-3水平正常者。
Objective To investigate the diagnostic value of 18F-FDG positron emission tomography (PET / CT) in the postoperative recurrence and metastasis of breast cancer and its relationship with carbohydrate antigen (carbohydrate antigen, CA) 15-3. Methods Forty-eight patients with postoperative suspected breast cancer recurrence and metastasis were examined with 18F-FDG PET / CT and compared with histopathological or clinical follow-up results to calculate the specificity of 18F-FDG PET / CT in the diagnosis of recurrence and metastasis (CA15-3≥25μg / L) in 26 cases and normal group (CA15-3 <25μg / L) in 22 cases. The levels of CA15-3 in 48 patients were detected. 18 F-FDG PET / CT recurrence detection rate. Results There were 34 cases of recurrence and metastasis confirmed by histopathology or clinical follow-up. There were 35 cases of positive lesions (including 2 cases of false positives) by 18F-FDG PET / CT. No abnormal metabolism was found in 13 cases (1 case of false negative) The sensitivity and specificity of postoperative recurrence and metastasis were 97.1%, 85.7%, 93.8% respectively, the positive predictive value was 94.3% and the negative predictive value was 92.3%. The detection rate of 18F-FDG PET / CT recurrence and metastasis Was 76.9%, normal group was 59.1%, no significant difference between the two groups (P> 0.05). Conclusion 18F-FDG PET / CT is of great value in the diagnosis of postoperative recurrence and metastasis of breast cancer and is suitable for patients with normal CA15-3 levels.