^18F-FDG-PET在妊娠绒毛膜癌临床诊疗中的应用  

Clinical value of ^(18)F-deoxyglucose positron emission tomography/computer tomography in diagnosis and treatment of choriocarcinoma

作　　者：辛小燕[1] 汪宏波[1] 兰晓莉[2] 

机构地区：[1]武汉华中科技大学同济医学院附属协和医院妇产科,430022 [2]华中科技大学同济医学院附属协和医院PET-CT中心,430022

出　　处：《临床肿瘤学杂志》2014年第2期160-163,共4页Chinese Clinical Oncology

摘　　要：目的探讨18F-脱氧葡萄糖正电子发射显影/电子计算机断层扫描成像(18F-FDG-PET)在妊娠绒毛膜癌临床诊疗中的应用价值。方法对2例妊娠绒毛膜癌患者多次同时行18F-FDG-PET检查与动态血绒毛膜促性腺激素(β-HCG)监测,分析双肺、肝脏及盆腔的代谢异常增高转移性病变情况。结果 1例患者发现双肺、肝脏及盆腔多处转移病灶,经EMACO方案化疗后动态血β-HCG渐转正常,18F-FDG-PET显示多处病灶趋渐转阴。另1例经化疗后复发,18F-FDG-PET显示原发癌灶无活性,但血β-HCG稍增高,行子宫全切除术,病理诊断提示妊娠绒毛膜癌,活性细胞存在,判定18F-FDG-PET呈假阴性。术后持续随访,血β-HCG均为阴性。结论18F-FDG-PET在妊娠绒毛膜癌临床诊疗中了解原发灶与转移灶特点,评估癌细胞活性具有较高的应用价值。结合血β-HCG监测,可降低18F-FDG-PET假阳性和假阴性,为临床上妊娠绒毛膜癌的诊疗提供可靠依据。Objective To investigate the clinical value of 18SF-deoxyglucose positron emission tomography/computer tomo- graphy （18SF-FDG-PET） in diagnosis and treatment of chorioearcinoma. Methods The lSF-FDG-PET with simultaneously monitoring serum beta-human chorionic gonadotrophin （β-HCG） was carried out on 2 cases with ehorioearcinoma. The increased metabolic abnor- malities in metastatic lesions of lung, liver and pelvic were observed. Results In one patient, is F-FDG-PET revealed the primary eho- riocarcinoma associated with pulmonary, liver and pelvis cavity metastases. The level of serum J3-HCG decreased to normal level gradu- ally and the SUVs of multiple lesions followed a normal distribution after EMA-CO chemotherapy. For another recurrence patient, serum 13-HCG increased and pathology diagnosis revealed that few viable cells existed by undergoing radical hysterectomy, but ISF-FDG-PET detected no uptake. Conclusion lSF-FDG-PET is useful in diagnosis and treatment of choriocareinoma by detecting the primary and metastasis sites, and possesses higher value in assessing eytoaetive. Simultaneously monitoring serum β-HCG can decrease the false positive rate and false negative rate of iSF-FDG-PET.

关 键 词：妊娠绒毛膜癌 正电子发射断层 计算机断层 绒毛膜促性腺激素 

分 类 号：R737.33[医药卫生—肿瘤]