Does CEA and CA 19-9 combined increase the likelihood of F-18-FDG in detecting recurrence in colorectal patients with negative CeCT?

作者：Panagiotidis Emmanouil^*; Datseris Ioannis E; Rondogianni Phoebe; Vlontzou Evangelia; Skilakaki Maria; Exarhos Demetrios; Bamias Aristotelis

来源：Nuclear Medicine Communications, 2014, 35(6): 598-605.

DOI：10.1097/MNM.0000000000000107

• colorectal malignancy
• CA 19-9
• negative CeCT
• carcinoembryonic antigen
• 18F-FDG PET/CT

Aim The purpose of this prospective study was to investigate the role of 2-(fluorine-18)-fluoro-2-deoxy-d-glucose (F-18-FDG) PET/computed tomography (CT) in the diagnosis of recurrent colorectal cancer (CRC) in patients with increased tumor markers and negative contrast-enhanced computed tomography (CeCT) results. Material and methods Forty-three patients (27 male; median age 66 years, range 31-93 years) with increasing tumor markers and negative CeCT during follow-up for treated CRC underwent F-18-FDG PET/CT examinations. The serum values of carcinoembryonic antigen (CEA) (n=29) and CA 19-9 (n=20) were normal after completion of treatment, with subsequent increasing concentrations. Results Among the 43 patients, F-18-FDG PET/CT was true positive in 32 (74.4%), false positive in two (4.7%), false negative in one (2.3%), and true negative in eight (1%) patients. On the patient-basis analysis, F-18-FDG PET/CT had a sensitivity of 97% (confidence interval: 0.82-0.99), a specificity of 80% (0.44-0.96), a positive predictive value of 94% (0.78-0.98), and a negative predictive value of 88% (0.5-0.99). There was no statistically significant correlation between CRC recurrence and CEA and CA19-9 levels (P=0.561 and 0.55, respectively). Only in the group of patients (n=6) with both tumor markers increased did F-18-FDG PET/CT have 100% accuracy in revealing recurrent disease. Conclusion F-18-FDG PET/CT is highly sensitive in the diagnosis of recurrent CRC in patients with increasing levels of tumor markers and negative CeCT regardless of the type or level of tumor marker; however, the combination of elevated CEA and CA 19-9 increases the likelihood of F-18-FDG in detecting recurrence.

• 出版日期2014-6