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A Comparison between Serum CA-125 and FDG-PET/CT for the Early Detection of Recurrent Ovarian Cancer

比較血清腫瘤指標CA-125及氟-18去氧葡萄糖正子電腦斷層造影於卵巢癌復發的早期診斷

摘要


背景:血清CA-125為偵測卵巢癌復發的最敏感的腫瘤指標,本研究的目的為比較血清腫瘤指標CA-125及氟-18去氧葡萄糖正子電腦斷層造影早期診斷卵巢癌病患復發及影響治療處置的能力。方法:44個病患共執行55次的氟-18去氧葡萄糖正子電腦斷層造影,分成兩組,血清CA-125≥35及<35U/mL但連續升高者為第一組,共27次,血清CA-125未升高者為第二組,共28次,統計結果由組織學檢查、疾病變化或臨床追蹤來計算,復發定義為氟-18去氧葡萄糖正子電腦斷層造影檢查後6個月內,影響治療處置乃依據病歷記錄。結果:共28例病患復發,在第一組中,25例氟-18去氧葡萄糖正子電腦斷層造影最後證實為復發,另1例雖未復發,但偵測到第二種癌病的存在,在第二組中,有一例後來被證實為復發。血清CA-125及氟-18去氧葡萄糖正子電腦斷層造影的靈敏性、專一性及準確性均分別為92.9%、96.3%及94.5%。氟-18去氧葡萄糖正子電腦斷層造影改變27.3%(15/55)的預定治療方式,分別為第一組的51.9%(14/27)及第二組的3.6%(1/28)(P<0.001)。結論:血清的腫瘤指標CA-125為偵測卵巢癌復發的敏感指標,氟-18去氧葡萄糖正子電腦斷層造影具有偵測復發病灶及影響治療處置的能力,我們結論氟-18去氧葡萄糖正子電腦斷層造影應與血清CA-125共同來早期偵測復發卵巢癌。

並列摘要


Background: Serum CA-125 is the most accurate tumor marker used for monitoring the therapeutic response of ovarian cancer, and observing the recurrence of disease if initial test results are high when cancer is first found. FDGPET/CT enables the evaluation of both metabolic activity and anatomy at the same location in the body, facilitating the recognition of local recurrence of ovarian cancer. The aim of this study is to compare the usefulness of serum CA- 125 and FDG-PET/CT for the early detection of recurrent ovarian cancer, and evaluate their effects on the clinical disease management. Methods: Fifty-five consecutive FDG-PET/CT analyses were performed on 44 patients who exhibited elevated serum CA-125 levels (≥ 35 U/mL) or progressive low-level increases in serum CA-125 levels (Group 1, n = 27), and those who exhibited no increase in serum CA-125 levels (Group 2, n = 28). The results were analyzed using histological data, disease progression, and clinical follow-up. Recurrence was defined as evidence of recurrent lesions within 6 months of the FDG-PET/CT scan. Any change in the planned management was calculated based on medical records. Results: Recurrence was evident in 28 patients. The FDGPET/ CT scan detected 25 cases of recurrent cancer and one case of second primary cancer in Group 1, and one case of recurrent cancer in Group 2. The overall sensitivity, specificity and accuracy were 92.9%, 96.3% and 94.5% respectively for both serum CA-125 and FDG-PET/CT. FDGPET/ CT induced changes in the planned management of 27.3% (15/55) of the patients: 51.9% (14/27) of Group 1 patients and 3.6% (1/28) of Group 2 patients (P < 0.001). Conclusion: Serum CA-125 is a sensitive tumor marker in recurrent ovarian cancer. FDG-PET/CT can be used to localize recurrent lesions and affect the course of disease management. We concluded that FDG-PET/CT should be used to detect recurrent ovarian cancer in conjunction with serum CA-125.

並列關鍵字

CA-125 FDG ovarian cancer PET/CT

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