^(18)F-FDG PET/CT显像在宫颈癌术后复发和转移中的应用价值  

Clinical Value of^(18)F-FDG PET/CT Imaging in Detecting Postoperative Recurrence and Metastasis of Cervical Cancer

作　　者：彭辽河[1] 胡晓燕[1] 邱大胜[1] 李蕾[1] 李杰[1] 朱佳[1] 

机构地区：[1]湖北省肿瘤医院PET/CT中心,430079

出　　处：《临床放射学杂志》2015年第4期600-604,共5页Journal of Clinical Radiology

摘　　要：目的探讨18F-FDG PET/CT显像在宫颈癌术后复发和转移中的应用价值。方法搜集临床可疑宫颈癌术后复发和转移患者65例,年龄23~77岁,平均48.7岁。所有宫颈癌患者均经手术病理确诊并行根治性治疗,其中鳞癌47例,腺癌12例,腺鳞癌4例,透明细胞癌1例,小细胞癌1例。患者均行18F-FDG PET/CT全身显像检查,采用目测法和半定量法判断结果,并与组织病理或临床随访结果比较其诊断的准确性,以及评价其诊断的真实性和可靠性。结果 65例患者经组织病理或临床随访证实50例复发和转移。18F-FDG PET/CT显像诊断肿瘤局部复发18例,肿瘤转移33例,复发和转移病灶的SUVmax 2.91~16.70,平均SUVmax 9.81,18F-FDG PET/CT显像诊断宫颈癌术后复发和转移的灵敏度为98.00%,特异性为86.67%,准确性为95.38%,阳性预测值为96.08%,阴性预测值为92.86%;18F-FDG PET/CT显像诊断结果与组织病理或临床随访结果比较差异无统计学意义(经χ2检验,P>0.05);二者结果的吻合度有统计学意义且吻合度较强(系数k=0.867,P=0.000)。结论18F-FDG PET/CT显像能够准确、直观地显示宫颈癌术后复发和转移,且真实性和可靠性好;同时18F-FDG PET/CT全身显像检查是肿瘤远处转移探测最有效的方法,可较全面评估患者病情,对协助临床确定个体化治疗方案具有重要价值。Objective To investigate the clinical value of^18F-FDG PET / CT imaging in the diagnosis of postoperative recurrence and metastasis of cervical cancer. Methods A total of 65 patients with clinically-suspected postoperative recurrence and metastasis of cervical cancer were collected for this study. The patients had a mean age of 48. 7 years old（ 23-77 years）. The diagnosis of cervical cancer was surgically and pathologically confirmed in all patients; the lesions included squamous carcinoma（ n = 47）,adenocarcinoma（ n = 12）,adenosquamous carcinoma（ n = 4）,clear-cell carcinoma（ n =1） and small cell carcinoma（ n = 1）.^18F-FDG PET / CT imaging of whole body was performed in all patients. Using visual method and semi-quantitative method to judge the results,and the diagnostic accuracy was compared with histopathologic findings or with the clinical follow-up results so as to evaluate the validity and reliability of the diagnosis. Results Among the 65 cases,50 had postoperative recurrence and metastasis,confirmed by histopathologic examination or clinical followup. PET / CT made diagnosis of recurrence in 18 cases and metastasis in 33 cases. The range of SUVmax of the local recurrent and metastatic lesions was 2. 91- 16. 70,with an average of 9. 81. Taking the results of histopathologic examination or clinical follow-up as reference standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of^18F-FDG PET / CT in the diagnosis of postoperative recurrence and metastasis of cervical cancers were98. 00%,86. 67%,95. 38%,96. 08% and 92. 86%,respectively. The differences were not statistically significant between^18F-FDG PET / CT and histopathological and follow-up judgment（ P〉0. 05）; strong agreement existed between the two,and the agreement degree was statistically significant（ k = 0. 867,P = 0. 000）. Conclusion^18F-FDG PET / CT imaging can correctly and directly display the postoperative recurrence and metastasis of cervical cancer with excellent v

关 键 词：宫颈癌 复发和转移 体层摄影术 发射型计算机 氟代脱氧葡萄糖 

分 类 号：R737.33[医药卫生—肿瘤] R730.44[医药卫生—临床医学]