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首页> 外文期刊>International journal of clinical oncology >Usefulness of fluoro-2-deoxyglucose positron emission tomography for investigating unexplained rising carcinoembryonic antigen levels that occur during the postoperative surveillance of lung cancer patients.
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Usefulness of fluoro-2-deoxyglucose positron emission tomography for investigating unexplained rising carcinoembryonic antigen levels that occur during the postoperative surveillance of lung cancer patients.

机译：氟-2-脱氧葡萄糖正电子发射断层扫描在调查肺癌患者术后监测期间发生的无法解释的癌胚抗原水平升高中的有用性。

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BACKGROUND: Positron emission tomography with 18-fluorodeoxyglucose (FDG-PET) has been useful for the detection of recurrent lung cancer. However, such technology is expensive and is not always widely available. In this study, we evaluated the selected use of FDG-PET for lung cancer patients with re-elevated levels of serum carcinoembryonic antigen (CEA) after curative surgery. METHODS: Among 327 patients who underwent curative resection for primary lung cancer from May 2002 through March 2007, 199 had adenocarcinoma, of whom 78 (39%) had elevated levels of serum CEA before treatment. After surgery, the level was monitored every 1 to 3 months. Re-elevation of CEA was recognized in 39 (50%) patients, 22 of whom underwent FDG-PET and were included in this study. FDG-PET images were visually inspected, and abnormally increased FDG uptake was interpreted as recurrence. The sensitivity, specificity, positive predictive value, and negative predictive value of PET in detecting recurrent lung cancer were determined. RESULTS: FDG-PET correctly identified 14 out of 15 relapses and gave true negative results in six out of seven remissions, i.e., one false-negative and one false-positive were observed. The sensitivity, specificity, positive predictive value, and negative predictive value were 93%, 86%, 93%, and 86%, respectively. CONCLUSION: In 64% of the patients with unexplained increased CEA levels, FDG-PET provided decisive diagnostic clues guiding further diagnostic and therapeutic interventions. The selected use of FDG-PET for patients with re-elevated serum CEA levels after surgery can be a practical and effective mode of surveillance for detecting recurrent lung cancer.
机译：背景：用18-氟脱氧葡萄糖（FDG-PET）进行的正电子发射断层扫描已用于检测复发的肺癌。但是，这样的技术很昂贵并且并不总是广泛可用。在这项研究中，我们评估了FDG-PET在治愈性手术后血清癌胚抗原（CEA）水平再次升高的肺癌患者中的选择性使用。方法：从2002年5月至2007年3月，对327例原发性肺癌进行根治性切除术的患者中，有199例患有腺癌，其中78例（39％）的患者治疗前血清CEA水平升高。手术后，每1至3个月监测一次该水平。 39例（50％）患者被确认为CEA升高，其中22例接受了FDG-PET治疗，并被纳入本研究。肉眼检查FDG-PET图像，并且异常增加的FDG摄取被解释为复发。确定PET在检测复发性肺癌中的敏感性，特异性，阳性预测值和阴性预测值。结果：FDG-PET正确识别了15例复发中的14例，并在7例缓解中的6例中给出了真正的阴性结果，即观察到1例假阴性和1例假阳性。敏感性，特异性，阳性预测值和阴性预测值分别为93％，86％，93％和86％。结论：在64％无法解释的CEA水平升高的患者中，FDG-PET提供了决定性的诊断线索，指导进一步的诊断和治疗干预。在手术后血清CEA水平升高的患者中选择使用FDG-PET可能是检测复发性肺癌的一种实用有效的监视方式。

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