^(18)F-FDG PET/CT在恶性黑色素瘤诊断及分期中的应用价值  

Application of ^(18)F-FDG PET/CT in diagnosis and staging of malignant melanoma

作　　者：胡莹莹[1] 林晓平[1] 梁培炎[1] 张旭[1] 张伟光[1] 樊卫[1] 

机构地区：[1]中山大学肿瘤防治中心核医学科,广东广州510060

出　　处：《中国医学影像技术》2009年第4期685-688,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨18F-FDGPET/CT在恶性黑色素瘤诊断及分期中的应用价值。方法回顾性分析61例恶性黑色素瘤患者18F-FDGPET/CT显像,对原发恶性黑色素瘤5例、原发灶未明的淋巴结转移性恶性黑色素瘤16例及恶性黑色素瘤原发灶(不全)切除40例,分别研究PET/CT诊断恶性黑色素瘤原发灶及转移瘤的应用价值。结果5例原发恶性黑色素瘤病灶均异常摄取FDG,SUV3.52～14.76,其中2例示区域淋巴结转移并经病理确诊。3例原发灶未明的淋巴结转移性恶性黑色素瘤经18F-FDGPET/CT检出原发灶,原发灶检出率18.75%,其中2例示远处多发转移;另2例患者临床体检发现原发灶,18F-FDGPET/CT未见原发征象。40例恶性黑色素瘤原发灶(不全)切除患者中,18F-FDGPET/CT诊断原发灶残留8例,经病理确诊5例,准确率62.50%;18F-FDGPET/CT示区域淋巴结转移7例,病理确诊5例,阳性预测价值71.43%;18F-FDGPET/CT示远处多发转移14例,远处转移率35.00%(14/40);40例患者中,2例因PET/CT显像降低临床分期,11例提高分期,18例患者治疗方案改变。结论18F-FDGPET/CT在恶性黑色素瘤准确分期方面有较大临床价值,但在淋巴结转移性恶性黑色素瘤寻找原发灶的价值有限。Objective To observe the application value of 18 F-FDG PET/CT in diagnosing and staging of malignant melanoma. Methods Sixty-one patients with malignant melanoma underwent ^18F-FDG PET/CT were enrolled and grouped according to different initial diagnosis： primary malignant melanoma （n=5）, lymph node metastatic malignant melanoma with-out primary signs （n=16） and malignant melanoma with primary sites resection or partly resection （n=40）. The application value of ^18F-FDG PET/CT in diagnosing and staging were assessed separately. Results All 5 primary malignant melanoma sites had increased FDG uptake, the SUVs were 3.52-14. 76 ; and regional lymph metastases were found in 2 patients among them and both were verified pathologically. In 3 of 16 patients with lymph node metastatic malignant melanoma, primary sites were detected, the primary detection rate was 18.75%. Distant metastases were found in 2 of these 3 patients, while 2 primary sites were found by clinical examination when PET/CT was false-negative. For the 40 malignant melanoma with primary sizes resection or partly resection, PET/CT showed suspicious residual in 8 patients, 5 were verified pathologi- cally, the accuracy was 62.50%. Regional lymph metastases were found in 7 of these 40 patients, 5 were verified pathologically, the positive predictive value was 71.43%. In 14 of 40 patients, distant metastases were found （35.00%）. With the use of PET/CT, the clinical stage was down-staged in 2 of 40 patients, up-staged in 11 patients, and therapies were changed in 18 of 40 patients. Conclusion 18 F-FDG PET/CT is of great importance in whole body tumor staging of malignant malenoma, but is inefficient in detecting primary sites of lymph node metastatic malignant melanoma.

关 键 词：黑色素瘤 氟脱氧葡萄糖 正电子发射断层显像术 体层摄影术 X线计算机 肿瘤分期 

分 类 号：R739.5[医药卫生—肿瘤] R817.4[医药卫生—临床医学]