氟代脱氧葡萄糖PET/CT在肝门部胆管癌术前评估中的价值  

Preoperative assessment of hilar cholangiocarcinoma by 18F-FDG PET/CT

作　　者：王越琦[1] 王吉文[1] 张德祥[1] 沈盛[1] 刘寒[1] 锁涛[1] 潘洪涛[1] 石洪成[2] 刘厚宝[1] 

机构地区：[1]复旦大学附属中山医院普外科,上海200032 [2]复旦大学附属中山医院核医学科,上海200032

出　　处：《中华肝胆外科杂志》2015年第3期173-176,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：上海市科学技术委员会科研计划项目（10411955500）

摘　　要：目的 探讨氟代脱氧葡萄糖（18 F-FDG）正电子发射计算机断层显像（PET）/CT对肝门部胆管癌患者的术前评估价值.方法 回顾性分析复旦大学附属中山医院30例术前PET/CT诊断为肝门部胆管癌患者的临床资料.统计分析PET/CT对肝门部胆管癌肿瘤定性、淋巴结转移和远处转移的诊断价值,以及不同肿瘤分期之间最大标准摄取值（SUVmax）的差异.结果 30例患者中14例（46.7％）行根治性切除术,16例（53.3％）行姑息性手术或经皮经肝胆汁引流（PTBD）术.4例（13.3％）经手术诊断为胆囊管癌侵犯肝门部.PET/CT对肝门部胆管癌原发肿瘤定性诊断的敏感度和特异度为100％和0,诊断淋巴结转移的敏感度和特异度为62.5％和90.0％,诊断远处转移的敏感度和特异度为66.7％和85.0％.不同TNM分期肿瘤组织SUVmax值差异无统计学意义（P＞0.05）.结论 18F-FDGPET/CT对术前评估肝门部胆管癌是否发生淋巴结转移和远处转移具有重要临床价值,可以使部分患者避免不必要的手术探查;不同分期的肿瘤SUVmax值差异无统计学意义.Objective To study the value of 18F-FDG PET/CT in the staging of hilar cholangiocarcinoma.Methods A retrospective study was conducted on 30 patients with hilar cholangiocarcinoma who were evaluated with PET/CT in Zhongshan Hospital,Fudan University.The study analyzed the operative and pathological results in each patient for tumor-node-metastasis staging and the SUVmax value.Results 14（46.7%） patients underwent radical surgery,and 16（53.3%） palliative operation or PTBD treatment.4 （13.3%） patients were shown to have a cystic duct carcinoma which infiltrated the hilum.The sensitivity and specificity in the detection of tumor,regional lymph node metastases and distant metastases were 100% and 0%,62.5% and 90.0%,66.7% and 85.0% respectively.The SUVmax value in the primary tumor was not significantly associated with the tumor-node-metastasis staging （P 〉 0.05）.Conclusions 18 F-FDG PET/CT imaging was useful in the detection of lymph node and distant metastasis in hilar cholangiocarcinoma,and helped some patients to avoid unnecessary surgical exploration.The SUVmax value had no significant association with tumor staging.

关 键 词：肝门部胆管癌 正电子发射计算机断层显像 肿瘤分期 

分 类 号：R735.8[医药卫生—肿瘤]