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目的探讨~(18)F-FDG PET/CT显像联合肿瘤标志物(TM)在NSCLC~(125)I粒子植入联合化疗的临床价值。方法回顾性分析2011年1月~2016年4月在PET/CT中心进行检查的48例非小细胞肺癌(NSCLC)患者的显像结果,均在粒子植入术前经病理学确诊,所有患者在~(125)I粒子植入联合化疗后6~12个月均行~(18)F-FDG PET/CT显像和血清TM(NSE,CEA,CYFRA21-1)检测,同时测量肿块在~(125)I粒子植入联合化疗后的最大标准摄取值(SUVmax),评价PET/CT联合TM与单纯CT显像对NSCLC~(125)I粒子植入联合化疗后局部肿瘤组织残留、复发及转移的诊断效能。结果 1~(18)F-FDG PET/CT显像联合TM与单纯CT显像对~(125)I粒子联合化疗治疗NSCLC预后评价的诊断效能比较48例患者中经病理及临床随访证实为治疗后局部残留、复发及转移者34例;其余14例证实无残留、复发及转移。两者检出NSCLC治疗后局部残留、复发及转移的灵敏度、特异性、准确性分别为97.1%(33/34),85.7%(12/14),93.8%(45/48);58.8%(20/34),64.3%(9/14),60.4%(29/48)。~(18)F-FDG PET/CT显像联合TM的灵敏度和准确性高于单纯CT显像(P均<0.05),两者特异性之间差异无统计学意义(P>0.05)。2~(18)F-FDG PET/CT显像对淋巴结转移以及远处转移诊断的灵敏度、特异性、准确性分别为91.1%(51/56),80.4%(37/46),86.3%(88/102)和92.1%(93/101),82.6%(19/23),90.3%(112/124)。结论~(18)F-FDG PET/CT显像联合TM对监测NSCLC~(125)I粒子植入联合化疗后局部残留、复发及转移具有较高的灵敏度、特异性和准确性,并能及时进行放化疗疗效评价。
Objective To investigate the clinical value of ~ (18) F-FDG PET / CT combined with tumor marker (TM) in NSCLC 125 I seed implantation combined with chemotherapy. Methods The imaging findings of 48 patients with non-small cell lung cancer (NSCLC) examined at the PET / CT center between January 2011 and April 2016 were retrospectively analyzed. All patients were pathologically diagnosed before particle implantation. The 18F-FDG PET / CT imaging and serum TM (NSE, CEA, CYFRA21-1) were detected in 6 ~ 12 months after ~ (125) I particle implantation combined with chemotherapy. (125) I particle implantation in combination with chemotherapy, and to evaluate the effect of PET / CT combined with pure CT imaging on the local tumor tissue retention, recurrence and metastasis after NSCLC 125 I seed implantation and chemotherapy Metastatic diagnostic efficacy. Results The diagnostic efficacy of 1 ~ (18) F-FDG PET / CT combined with TM and CT imaging in evaluating the prognosis of NSCLC with ~ (125) I particle chemotherapy was confirmed by pathology and clinical follow-up in 48 patients After the local residual, recurrence and metastasis in 34 cases; the remaining 14 cases confirmed no residue, recurrence and metastasis. The sensitivity, specificity and accuracy of detecting local residual, recurrence and metastasis of NSCLC were 97.1% (33/34), 85.7% (12/14), 93.8% (45/48) and 58.8% 20/34), 64.3% (9/14), 60.4% (29/48). The sensitivity and accuracy of ~ (18) F-FDG PET / CT imaging combined with TM were higher than those of pure CT imaging (all P <0.05). There was no significant difference between the two (P> 0.05). The sensitivity, specificity and accuracy of 2 ~ (18) F-FDG PET / CT imaging in diagnosis of lymph node metastasis and distant metastasis were 91.1% (51/56), 80.4% (37/46) and 86.3% 88/102) and 92.1% (93/101), 82.6% (19/23), 90.3% (112/124). Conclusions ~ (18) F-FDG PET / CT combined with TM has high sensitivity, specificity and accuracy in monitoring the local residual, recurrence and metastasis of NSCLC 125 I seed implantation combined with chemotherapy Radiotherapy and chemotherapy efficacy evaluation.