^18F-FDG PET／CT显像诊断妇科肿瘤复发、转移的价值  

Value of ^18F-FDG PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies

作　　者：张敬勉[1] 赵新明[1] 王建方[1] 王颖晨[1] 张召奇[1] 李德志[1] 戴春暖[1] 孙莉[1] 江志华[1] 

机构地区：[1]河北医科大学第四医院核医学科、PET/CT中心,石家庄050011

出　　处：《中华核医学杂志》2009年第4期234-237,共4页Chinese Journal of Nuclear Medicine

基　　金：河北省普通高等学校强势特色学科肿瘤学组课题（冀教高[2005]52）;河北省卫生厅科研课题（06006）

摘　　要：目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像诊断妇科肿瘤复发、转移的价值，并评价其对临床再分期及治疗决策的影响。方法对47例临床可疑复发、转移的妇科肿瘤患者行^18F—FDG PET／CT显像，对PET、CT及PET／CT图像进行对比分析。采用SPSS12．0软件，对数据行∥检验、校正的，检验及确切概率法分析。结果47例患者中共发现病灶158处，其中恶性病灶149处，良性病灶9处。^18F-FDG PET／CT诊断妇科肿瘤复发、转移的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为95．97％（143／149），6／9，94．30％（149／158），97．95％（143／146）及50．00％（6／12）。PET／CT在诊断妇科肿瘤复发、转移的灵敏度、准确性及阴性预测值方面明显优于单纯CT（χ^2=18．198，18．890，6．825，P均〈0．05）；^18F-FDG PET／CT和单纯PET在各项诊断效能指标间差异无统计学意义（χ^2=0．632，0．000，0．459，0．000，0．150，P均〉0．05），但PET／CT使33．54％（53／158）的单纯PET无法准确定位的病灶得到了准确定位。同单纯CT及PET相比，PET／CT分别使44．68％（21／47）和31．91％（15／47）的患者TNM分期改变，对T分期的影响最明显；共有19．15％（9／47）的患者临床分期改变，并改变相应的治疗决策。结论^18F—FDG PET／CT显像诊断妇科肿瘤复发、转移准确而全面，对临床再分期及治疗决策有重要影响。Objective Recurrence and metastasis are significant prognostic factors in patients with gynecological malignancies. The purpose of the study was to evaluate the value of ^18 F-fluorodeoxyglucose （FDG） PET/CT in diagnosing suspected recurrence and metastasis in gynecological malignancies, and to investigate the influence of PET/CT on clinical restaging and treatment decision. Methods Forty-seven patients with gynecological malignancies clinically suspected of recurrence or metastasis underwent ^18 F-FDG PET/CT imaging. The images of ^18F-FDG PET/CT, PET and CT were compared respectively, χ^2-test with SPSS 12.0 was used for data analysis. Results One hundred and forty-nine malignant lesions and 9 benign lesions were found in 47 patients. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ^18F-FDG PET/CT in detecting recurrence and metastasis of gynecological malignancies were 95.97% （ 143/149）, 6/9, 94.30% （ 149/158 ）, 97.95% （143/146） and 50.00% （6/12）, respectively. The difference was significant between ^18F-FDG PET/CT image and CT alone in sensitivity, accuracy and negative predictive value （χ^2 = 18. 198, 18. 890, 6. 825, all P 〈0.05）. Compared with ^18F- FDG PET/CT image, PET alone had no difference in the qualitative diagnostic accuracy （χ^2 = 0. 632, 0. 000, 0. 459, 0. 000, 0. 150, all P 〉 0.05 ）, but ^18F-FDG PET/CT had a clear advantage in determining the location of the lesions [ 33.54% （53/158） ]. PET/CT changed the TNM staging in 44.68% （21/47） and 31.91% （15/47） patients, respectively, comparing with CT or PET alone. Furthermore, 19. 15% （9/47） had change in their clinical staging and treatment decision based on the results of PET/CT. Conclusion ^18F-FDG PET/CT is valuable in the detection, restaging and management decision in recurrent and metastatic gynecological malignancies.

关 键 词：生殖器肿瘤 女性 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]