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探讨肿瘤标记物癌胚抗原(CEA)测定对~(18)F-FDG PET/CT发现直结肠FDG局灶性高代谢灶癌变判断的临床价值。回顾性分析56例意外探测到结直肠局灶性高摄取灶病例,同时行血清CEA测定,将肠镜及病理结果作为标准分组。各组血清CEA水平数据汇总后行单因素方差分析及计算血清CEA水平测定的诊断效率。结果表明:56例结肠局灶性高代谢病灶中,结肠镜及病理检查出结肠癌及腺瘤共43例,阳性预测值(PPV)为76.8%;其中直结肠癌26例,腺瘤17例,其余13例(23.2%)为炎性及生理性改变。结肠癌组、腺瘤组及良性病变组(炎性和生理性摄取)的血清CEA水平分别为(15.0±17.1)μg/mL,(2.23±0.96)μg/mL,(2.51±0.90)μg/mL,恶性病变组与腺瘤组及正常组之间具有显著性差异,F=8.277,P=0.001。结肠癌组与癌前病变组及生理及炎性组之间P值分别为0.001和0.001。血清CEA水平探测局灶性浓聚灶结肠癌变的敏感性、特异性和准确率分别为:84.6%、83%和83.9%。说明~(18)F-FDG PET/CT偶然发现结肠局灶性高摄取病灶中癌前病变和恶性病变阳性率很高,血清CEA水平对局灶性直结肠偶发FDG浓聚灶的恶变诊断具有高的诊断价值。
To investigate the clinical value of tumor marker carcinoembryonic antigen (CEA) in the detection of 18 F-FDG PET / CT in the diagnosis of focal hypermetabolic lesions of the colon FDG. Retrospective analysis of 56 cases of incidental detection of colorectal focal high focal lesions cases, while serum CEA determination, the colonoscopy and pathological results as a standard group. The data of serum CEA levels of each group were collected and analyzed by one-way ANOVA and the diagnostic efficiency of serum CEA level calculation. The results showed that colon and adenoma colonoscopy and pathological examination were found in 43 cases of colon with high metabolic lesions in 43 cases, with a positive predictive value (PPV) of 76.8%. Among them, 26 cases of colon cancer and 17 cases of adenoma , The remaining 13 cases (23.2%) were inflammatory and physiological changes. The serum levels of CEA in colon cancer group, adenoma group and benign lesion group were (15.0 ± 17.1) μg / mL, (2.23 ± 0.96) μg / mL and (2.51 ± 0.90) μg / mL, there was a significant difference between malignant group and adenoma group and normal group (F = 8.277, P = 0.001). The P values of colon cancer group, precancerous lesions group, physiological and inflammatory group were 0.001 and 0.001, respectively. The sensitivity, specificity and accuracy of serum CEA level in detecting focal focal colon cancer were 84.6%, 83% and 83.9%, respectively. Description ~ (18) F-FDG PET / CT occasionally found in high-risk focal colon lesions high positive rate of precancerous lesions and malignant lesions, serum CEA levels in focal colorectal FDG fusion lesions of malignant lesions have High diagnostic value.