^(18)F-FDG符合线路显像在食管癌术前分期中的价值  

The value of ^(18)F-FDG coincidence SPECT in the initial staging of patients with esophageal cancer

作　　者：郁春景[1] 万卫星[1] 尤徐阳[1] 陆燕君[1] 杜晓庆[1] 吴娜静[1] 

机构地区：[1]无锡市第四人民医院,苏州大学附属第四医院核医学科,214062

出　　处：《中华核医学杂志》2007年第5期272-274,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^(18)F-FDG 符合线路显像在食管癌术前分期中的价值。方法 35例食管癌患者术前行^(18)F-FDG 符合线路显像及 CT 检查,其中30例行手术治疗,以术后病理检查结果作为"金标准",比较^(18)F-FDG 符合线路显像及 CT 检查对原发肿瘤、淋巴结及远处转移(TNM)分期的价值;另5例发现远处转移,放弃手术治疗。结果 ^(18)F-FDG 符合线路显像 T 分期与病理 T 分期比较符合率为63%(19/30);^(18)F-FDG 与 CT 探测淋巴结病变的灵敏度为60.00%和54.28%,特异性为94.44%和77.77%,准确性为84.80%和71.20%,阴性预测值为85.86%和81.39%,阳性预测值为80.77%和48.72%,其中特异性、准确性及阳性预测值差异有统计学意义。^(18)F-FDG 符合线路显像发现5例远处转移,改变了其治疗方案。结论 ^(18)F-FDG 符合线路显像对食管癌的术前分期、治疗方案的制定有临床应用价值。Objective Exact preoperative staging of esophageal cancer is essential for accurate prognosis and selection of appropriate treatment. The aim of this study was to assess the value of ^18F-FDG coincidence SPECT in the initial staging of patients with esophageal cancer. Methods ^18F-FDG coincidence SPECT and CT were performed and interpreted before operation in 35 patients with newly diagnosed esophageal cancer. The results were then compared with the corresponding post surgical histology in terms of tumor, nodal, and metastatic （TNM） disease status. Thirty patients were finally operated; the rest 5 had distant metastases. Results Local tumor staging （T） was obtained correctly by ^18F-FDG coincidence SPECT in 63% （19/30） patients. Based on ^18F-FDG coincidence SPECT analysis, the sensitivity in lymph node metastasis was 60.00% , the specificity 94.44% , with a diagnostic accuracy of 84.80%. The negative and positive predictive value of ^18F-FDG coincidence SPECT was 85.86% and 80. 77% , respectively. CT resulted in a sensitivity of 54.28% , specificity of 77.77% , and accuracy of 71.20%. The negative predictive value of CT was 81.39% and the positive predictive value 48.72%. There were significant differences in specificity, accuracy, and positive predictive value between ^18 F-FDG coincidence SPECT and CT. Conclusion ^18F-FDG coincidence SPECT can be used as an important tool for the initial staging and treatment planning of the patients with esophageal cancer.

关 键 词：食管肿瘤 肿瘤分期 体层摄影术 发射型计算机 单光子 脱氧葡萄糖 

分 类 号：R735.1[医药卫生—肿瘤]