影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (2): 218-224.DOI: 10.7517/issn.1674-0475.190819

• 综述与论文 • 上一篇    下一篇

18F-FDG PET/CT显像联合肿瘤标志物检查对女性不明原因腹腔积液的诊断价值

谢燃1, 杨清雄2   

  1. 1. 云南省肿瘤医院(昆明医科大学第三附属医院) PET/CT中心, 云南 昆明 650118;
    2. 昆明市儿童医院 放射科, 云南 昆明 650034
  • 收稿日期:2019-08-21 出版日期:2020-03-15 发布日期:2020-03-15
  • 基金资助:
    云南省科技厅-昆明医科大学应用基础研究联合专项[2017FE467(-189)]和云南省卫生厅科技计划项目(2017NS201)资助

Diagnostic Value of 18F-FDG PET/CT Imaging Combined with Tumor Markers in Unexplained Peritoneal Effusion in Women

XIE Ran1, YANG Qingxiong2   

  1. 1. The Center of PET/CT, Yunnan Cancer Hospital & The Third Affiliated Hospital of Kunming Medical University, Kunming 650118, Yunnan, P. R. China;
    2. Department of Radiology, Kunming Children's Hospital, Kunming 650034, Yunnan, P. R. China
  • Received:2019-08-21 Online:2020-03-15 Published:2020-03-15
  • Supported by:
     

摘要: 本文探讨了18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层显像(PET/CT)联合肿瘤标志物检查对女性不明原因腹腔积液的鉴别诊断价值。选取95例不明原因腹腔积液女性患者的18F-FDG PET/CT影像资料及肿瘤标志物资料进行回顾性分析,并与病理诊断结果进行对照。结果显示:95例患者中,经病理证实恶性腹腔积液74例,良性腹腔积液21例。PET/CT对良恶性腹腔积液的诊断灵敏度为98.65%,特异度为19.05%,准确度为81.05%。恶性腹腔积液的SUVmax与良性腹腔积液比较,差异无统计学意义(P>0.05)。将患者按病因进一步细分后发现,卵巢癌组的SUVmax明显高于其他良性原因组(P<0.05),但与结核组和其他恶性肿瘤组比较,差异无统计学意义(P>0.05)。肿瘤标志物中以CA125检测效率最高,其对卵巢癌及结核所致腹腔积液的诊断灵敏度为98.2%,特异度为7.7%,准确度为81.4%。PET/CT和CA125联合诊断对卵巢癌及结核所致腹腔积液的灵敏度、特异度及准确度与单一PET/CT或CA125诊断比较差异均无统计学意义(P>0.05)。本实验表明18F-FDG PET/CT诊断女性不明原因腹腔积液的良恶性有较高的灵敏度和准确度,但特异性较差,联合肿瘤标志物检查并不能提高对卵巢癌及结核所致腹腔积液的诊断效能。

 

关键词: 不明原因腹腔积液, 18F-FDG, PET/CT, 肿瘤标志物

Abstract: The aim of this paper is to investigate the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) combined with tumor markers in diagnosis of unexplained peritoneal effusion in women. The 18F-FDG PET/CT imaging data and tumor markers of 95 women with unexplained peritoneal effusion were retrospectively analyzed and compared with the pathological diagnosis. In the 95 patients, 74 patients were malignant and 21 patients were benign. The diagnostic sensitivity, specificity and accuracy of PET/CT for benign and malignant ascites were 98.65%, 19.05% and 81.05%, respectively. The SUVmax of malignant peritoneal effusion was significantly higher than that of benign peritoneal effusion (P>0.05). The patients were further subdivided according to the etiology, SUVmax in ovarian cancer group was significantly higher than that in group of other benign causes (P<0.05), but there was no significant difference between the ovarian cancer group, the tuberculosis group and other malignant tumors group (P>0.05). CA125 was the most effective marker for the diagnosis of ovarian cancer and tuberculosis-induced peritoneal effusion. The sensitivity, specificity and accuracy of CA125 were 98.2%, 7.7% and 81.4%, respectively. There was no significant difference between the diagnosis of CA125 or PET/CT alone and the combined diagnosis of them (P>0.05). The research shows that 18F-FDG PET/CT has high sensitivity and accuracy in the diagnosis of unexplained peritoneal effusion in women, but its specificity is poor. Combined examination of tumor markers can not improve the diagnosis of ascites caused by ovarian cancer and tuberculosis.

Key words: unexplained peritoneal effusion, 18F-fluorodeoxyglucose, positron emission tomography/computed tomography, tumor markers

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