摘要
背景与目的:宫颈癌患者治疗后早期、正确诊断复发并积极治疗可改善预后。血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCAg)是检测无症状复发性宫颈癌最常用的肿瘤标志物。研究表明,宫颈癌随访期间血清SCCAg升高提示肿瘤复发,但并非所有随访SCCAg升高的宫颈癌患者经体格检查及传统影像均能探测到复发病灶。本研究探讨18F-FDGPET/CT在宫颈癌随访血清SCCAg升高中的应用,评估SCCAg升高在宫颈癌随访中的价值。方法:对宫颈癌随访血清SCCAg升高并在中山大学肿瘤防治中心行18F-FDGPET/CT显像检查的31例患者进行回顾性分析,记录患者的病理类型、随访SCCAg升高水平、PET/CT显像结果、其他影像检查结果、病理及临床随访结果。结果:31例患者均为宫颈鳞癌,包括3例鳞腺癌。所有患者均经PET/CT探测到病灶,PET/CT诊断宫体或阴道局部复发3例,转移28例;最终经病理或临床证实局部复发3例,转移27例,原发肺鳞癌1例;PET/CT探测恶性病变率为100%(31/31),诊断宫颈癌复发准确率为96.8%(30/31)。随访血清SCCAg值为1.5～37.8pg/L,SCCAg值与PET/CT病灶最大标准化摄取值(SUVmax)无相关性。与其他影像检查相比,PET/CT明显提高探测效率,发现更多的病灶。结论:宫颈癌治疗后随访血清SCCAg升高提示肿瘤复发,PET/CT能有效探测病灶,并具有较高的准确率。
Background and Objective： Accurate and early diagnosis of recurrence for cervical cancer after the treatment and aggressive salvage treatment could improve the prognosis of this disease. Serum squamous cell carcinoma antigen （SCCAg） is the most commonly used tumor marker for the detection of asymptomatic recurrence of cervical cancer. This study was to evaluate the application and value of ^18F-FDG PET/CT in cervical cancer with elevated of serum SCCAg level during the follow-up. Methods. Thirty-one patients with cervical cancer with elevated serum SCCAg level during the follow-up undergoing ^18F-FDG PET/CT in Sun Yat-sen University Cancer Center between August 2005 and November 2008 were entered into this retrospective study. The pathological types, the serum SCCAg level, PET/CT results, results of other imaging modalities, pathological and clinical followups were recorded. Results. All 31 patients＇ pathological examination showed squamous cell carcinoma, including three adenosquamous carcinoma. Lesions of all patients were examined by PET/CT. Three patients had local recurrence in the uterus or vagina, 28 had metastatic disease. Of these 31 patients, three were confirmed to have local recurrent disease, 27 were verified to have metastatic disease and one was diagnosed as primary lung squamous cell carcinoma by pathological or clinical manifestations. The total detection rate of PET/CT for malignancy was 100% （31/31）; the diagnostic accuracy of PET/CT for recurrent cervical cancer was 96.8% （30/31）. The levels of serum SCCAg during the follow-up were 1.5-37.8 ng/ ml. There was no relation between the level of serum SCCAg and the maximum standard uptake value （SUVmax） of PET/CT. Compared with other imaging modalities, PET/CT was more efficient in detecting recurrence and finding more lesions. Conclusions： An elevated level of SCCAg in cervical cancer during the follow-up indicates tumor recurrence. PET/CT is efficient in detecting the recurrence and has high diagnostic accuracy.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2009年第9期994-999,共6页
Chinese Journal of Cancer
