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The differential diagnosis of pancreatic duct a ladenocarcinoma and pancreatic neuroendocrine tumors using 18F⁃FDG PET/CT combined with serum CA19⁃9， CEA and NSE
Received date: 2023-04-14
Online published: 2023-10-10
Objective To discuss the value of 18F?FDG PET/CT combined with serum CA19?9， CEA and NSE in the differential diagnosis pancreatic ductal adenocarcinoma（pDAC） and pancreatic neuroendocrine tumors（pNETs）. Methods Retrospective analys is of patients who were diagnosed as pDAC or pNETs by pathology， including the clinical data， 18F?FDG PET/CT images and the level of tumor markers CA19?9， CEA and NSE， and compared age， sex， size and location of the lesions， the involvement of pancreatic ductal， the morphology of the lesionson PET image， SUVmax， surrounding lymphatic metastasis and hepatic metastasis and the level of serum CA19?9， CEA， NSE between the two groups， and figure out the effective indicators in differential diagnosis. The diagnostic efficacy of 18F?FDG PET/CT imaging SUVmax combined with serum CA19?9， CEA and NSE was compared. Results There were 74 patients were included. The age were between 46 and 82（66.48 ± 8.84）， and 32 were male， 32 were female. 46 patients were pDAC， 28 were pNETs. The mean value of SUVmax were （5.55 ± 2.01） in pDAC group， （4.62 ± 2.01） in pNETs group. It was not statistically significant between the two groups in sex， morphology of the lesions in PET image， SUVmax， surrounding lymphatic metastasis（P > 0.05）， and was statistically significant in age， size of the lesions， location of the lesions， the involvement of pancreatic ductal hepatic metastasis and serum CA19?9， CEA， NSE（P < 0.05）. The diagnostic efficacy of SUVmax combined with serum CA19?9， CEA and NSE was improved compared with SUVmax， which SUVmax combined with CA19?9 had the best diagnostic efficacy with the AUC of ROC curve was 0.891 （95%CI： 0.816～0.967， P < 0.001）. Conclusion The using of 18F?FDG PET/CT combined with serum CA19?9， CEA， NSE has a high differential diagnosis value in pancreatic ductal adenocarcinoma and pancreatic neuroendocrine tumors， that make up the shortage of using 18F?FDG PET/CT alone， which the diagnostic efficiency of SUVmax combined with CA19?9 was the best.
Lichun ZHENG , Huan ZHANG , Cheng GU , Xinyu SHEN , Xiaoming ZHANG , Xiangliu. OUYANG . The differential diagnosis of pancreatic duct a ladenocarcinoma and pancreatic neuroendocrine tumors using 18F⁃FDG PET/CT combined with serum CA19⁃9， CEA and NSE[J]. The Journal of Practical Medicine, 2023 , 39(18) : 2395 -2400 . DOI: 10.3969/j.issn.1006-5725.2023.18.019
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