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Purpose of 18F-FDG PET / CT examination recurrence after surgery for colorectal cancer patients, the sensitivity and specificity of the transfer are higher, but there are still some false-positive and false-negative diagnosis. Serum CEA is the most commonly used clinical tumor markers, regular monitoring of serum CEA levels for patients with colorectal cancer postoperative recurrence and metastasis has a significant role in assessment, but also there are a lot of uncertainties. 18F-FDG PET / CT examination and serum CEA in combination, so that the two complement each other and will greatly improve the accuracy of diagnosis of recurrence and metastasis in patients with colorectal cancer surgery. The topic by studying 75 cases of colorectal cancer surgery suspicious recurrence and metastasis in patients with systemic 18F-FDG PET / CT examination and serum CEA test results, to investigate the 18F-FDG PET / CT examination and serum CEA detection in colorectal postoperative recurrence and clinical value in the transfer. Information and screening methods Molecular Imaging Center in Qingdao Central Hospital 75 cases of whole body 18F-FDG PET / CT examination after colorectal cancer surgery patients, including 42 males and 33 females, aged 37-82 years (mean age for the 60.3 years). All subjects caught before checking in 18F-FDG PET / CT detection of serum CEA, and all the results were compared with the final pathology or clinical follow-up results. Depending on the level of serum CEA patients were divided into two groups: the first group, elevated serum CEA group, the group of 35 patients, serum CEA higher than the reference value of the upper limit of suspicious recurrence and metastasis. The second group, with normal serum CEA group, the group of 40 patients. The group, according to the presence or absence of clinical symptoms and conventional imaging studies whether suspicious in turn divided into A, B groups. Group A: 24 patients with no clinical symptoms or conventional imaging studies no suspicious recurrence and metastases. Group B: 16 patients with obvious blood in the stool, intestinal obstruction, abdominal pain, fever and other symptoms, or conventional imaging studies suspicious recurrence and metastases. The detection of serum CEA and conventional imaging studies were completed before the inspection of 18F-FDG PET / CT. 18F-FDG PET / CT examination instrument of the German company Siemens 16-slice CT 39 ring PET, Biograph16-type scanner. All patients with head and body imaging, self-parietal to the proximal femur scan. Scan first low-dose with the machine spiral CT scan, the PET emission scanning. The PET scan image obtained by attenuation correction, reconstruction, and other post-processing to obtain a tomographic image, and then the tomographic image obtained with the CT scan integration, multi-faceted on the workstation display. The resulting image by two experienced PET / CT diagnostic physician at the workstation alone and reading by visual method and a semi-quantitative analysis for PET, CT, PET / CT three image judgment benign and malignant lesions, and then parts as well as the distribution range of patients with or without recurrence, transfer to make the diagnosis and the records of patients with lesions, evaluation of patients with systemic tumor burden. The final diagnosis of the patients in the study by surgery, biopsy be confirmed by pathology or clinical follow-up conventional imaging studies confirmed. 18F-FDG PET / CT diagnosis, serum CEA in the final diagnosis of three results were analyzed, calculated 18F-FDG PET / CT examination for colorectal cancer patients after relapse, the transfer of diagnostic accuracy, sensitivity, specificity , PPV and NPV, explore 18F-FDG PET / CT examination combined with serum CEA monitoring the clinical value of detecting recurrence and metastasis after colorectal cancer surgery patients. The results of this study, 75 patients with 18F-FDG PET / CT diagnosis results: 35 patients with PET / CT diagnosis no postoperative recurrence or metastasis (2 patients, PET / CT found colorectal limitations of high metabolic stove, after confirmed by pathology intestinal adenoma; patients, PET / CT diagnosis of primary lung cancer, after the patients with pathologically confirmed squamous cell carcinoma). 40 patients, PET / CT diagnosis of recurrence, metastasis (17 patients diagnosed with local recurrence, metastasis, and 23 patients with a diagnosis of multiple recurrence, metastasis). 75 patients by surgery, biopsy confirmed pathologically or clinically conventional imaging studies follow-up results of the final diagnosis: 37 patients, the final diagnosis of postoperative recurrence, metastasis, and clinical follow-up of 12 months or more to be confirmed. 38 patients with a final diagnosis for recurrence or metastasis (16 patients with local recurrence, metastasis, 22 patients with multiple recurrence, metastasis, were confirmed by surgery, biopsy or clinical follow-up conventional imaging examination confirmed). Control and the final diagnosis results of this study, 75 cases of colorectal cancer patients after 18F-FDG PET / CT check the correct diagnosis of 69 cases, 4 false-positive diagnosis of local recurrence (2 cases of anastomotic inflammatory changes misdiagnosed cases of liver abscess misdiagnosed as liver metastases, one cases of pulmonary inflammatory pseudotumor misdiagnosed as lung metastases), 2 false-negative diagnosis (2 cases of mucinous adenocarcinoma recurrence were not detected). In this study, 18F-FDG PET / CT examination of patients with colorectal cancer surgery recurrence, the transfer of diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 92.0%, 94.7%, 89.2%, 90.0%, 94.3%. Conclusion 18F-FDG PET / CT checks for the evaluation of patients with colorectal cancer surgery recurrence, metastasis diagnosis with high clinical value, and conventional imaging studies is not clear qualitative lesions for diagnosis and differential diagnosis, and at the same time understand the patient systemic tumor load, to help clinicians to further develop a more standardized treatment program. Serum CEA level after surgery for colorectal cancer patients are able to make a more definitive diagnosis. However, 18F-FDG PET / CT to check itself there is a certain false-positive rate and false negative rate, serum CEA detection of recurrence and metastasis in colorectal cancer surgery patients in the early judgment also has important clinical value, but the same with a certain degree of inaccuracy, if their combination is able to significantly improve the accuracy of the on colorectal cancer postoperative recurrence and metastasis diagnosis.
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