^(18)F-FDGPET/CT显像在食管癌分期时发现同时性重复癌的价值  

Value of^(18)F-FDG PET/CT in detecting synchronous primary neoplasms for initial stage of esophageal cancer

作　　者：周雯[1] 朱湘[2] 王健[2] 徐文贵[2] 

机构地区：[1]天津医科大学药学院,天津市临床药物关键技术重点实验室,天津300070 [2]天津医科大学肿瘤医院分子影像及核医学诊疗科,国家肿瘤临床医学研究中心,天津市"肿瘤防治"重点实验室,天津300060

出　　处：《天津医科大学学报》2015年第5期404-407,共4页Journal of Tianjin Medical University

摘　　要：目的:探讨18F-FDG PET/CT显像在食管癌分期时发现同时性重复癌的价值。方法:回顾性研究171例病理证实的食管癌患者应用18F-FDG PET/CT显像进行分期的影像资料,位于食管癌常见转移部位以外的18F-FDG代谢增高灶,或代谢方式和程度与原发灶明显不一致者,首先考虑同时性重复癌,并根据病灶部位经手术、内镜或穿刺活检等获得病理学结果。结果:171例病理证实的食管癌患者中,病理诊断重复癌35例,其中18F-FDG PET/CT和病理共同诊断阳性的重复癌33例,部位依次为下咽癌14例、肺癌8例、胃癌6例、舌癌2例、乙状结肠癌1例、口咽癌1例,还有1例同时发现乙状结肠癌及胃癌。18F-FDG PET/CT诊断重复癌的灵敏度为94.3%,特异性为94.2%,准确性为94.2%。结论:应用18F-FDG PET/CT显像进行食管癌分期时可以有效发现同时性重复癌,显像阳性患者术前必须进一步明确病变的性质,将会直接影响治疗计划和预后。Objective：To determine the additional clinical value of 18F-FDG PET/CT in detecting synchronous neoplasms in initial stage of esophageal cancer. Methods：171 patients with biopsy-proven malignancy of the esophagus underwent 18F-FDG PET for initial stage. Synchronous malignancies were defined by abnormal 18F-FDG uptake on 18FDG-PET which was unlikely due to distant metastases from the primary esophageal lesion depending on intensity and pattern,and confirmed by pathology. Results： Thirty-five synchronous primary neoplasms were identified in 171 patients and 33 neoplasms were PET/CT-positive. Among them. 14 neoplasms were discovered in the laryngeal pharynx, 8 in the lung, 6 in the stomach, 2 in the tongue, 1 in the sigmoid colon, 1 in the oral pharynx and 1 in both stomach and sigmoid colon. The sensitivity, specificity and accuracy of 18F-FDG PET/CT were 94.3%, 94.2%and 94.2%,respectively. Conclusion： 18F-FDG PET can detect unexpected synchronous primary neoplasms in patients with esophageal cancer. Sites of pathologic 18F-FDG uptake should be confirmed by additional investigations before treatment, because synchronous neoplasms may cause metastases and influence the therapeutic plan.

关 键 词：食管癌 PET/CT 重复癌 分期 

分 类 号：R735.1[医药卫生—肿瘤] R730.4[医药卫生—临床医学]