^(18)F-FDG PET/CT在行结肠癌检查时发现同时性重复癌的价值  

The value of^(18)F-FDG PET/CT in detecting synchronous primary malignant neoplasms in patients with colon cancer

作　　者：朱湘[1] 宋秀宇[1] 王健[1] 徐文贵[1] 

机构地区：[1]天津医科大学肿瘤医院分子影像及核医学诊疗科,天津300060

出　　处：《国际医学放射学杂志》2016年第2期116-119,共4页International Journal of Medical Radiology

基　　金：国家科技重大项目(2013ZX09303001)

摘　　要：目的探讨18氟-氟脱氧葡萄糖(18F-FDG)PET/CT用于检查结肠癌时发现同时性重复癌的价值。方法回顾性分析232例经病理证实结肠癌病人的18F-FDG PET/CT影像资料和临床病理结果,采用卡方检验比较18F-FDG PET/CT结果与病理结果并行kappa系数一致性检验,分析PET/CT显像的诊断效能。结果 232例病理证实的结肠癌病人中,56例病理证实为重复癌。18F-FDG PET/CT诊断真阳性53例,假阳性4例,其中2例经肠镜病理证实分别为息肉和管状腺瘤(癌前病变),1例病理证实为甲状腺腺瘤,1例为肺炎性假瘤。假阴性3例,其中1例为胃窦部印戒细胞癌,1例为肾透明细胞癌,另1例18F-FDG PET/CT显像为高代谢,诊断为结肠癌肝转移,结果病理证实为结肠癌+原发性肝癌。18F-FDG PET/CT诊断重复癌的敏感度为94.64%,特异度为97.58%,准确度为96.83%,阳性预测值92.98%,阴性预测值98.17%。与病理诊断结果比较,两者间差异无统计学意义(P≈1.000),而且两者间一致性良好(κ=0.917,P=0.000)。结论应用18F-FDG PET/CT进行结肠癌检查时可以有效发现同时性重复癌。Objective To investigate the value of18F-FDG PET/CT in detecting synchronous primary malignant neoplasms in patients with colon cancer. Methods 232 cases with pathology-proven colon cancer who underwent18F-FDG PET/CT imaging were retrospectively evaluated in the study. By comparing with the pathological diagnosis with chi square test and the kappa coefficient test, the diagnostic efficacy of PET/CT imaging for synchronous primary malignant neoplasms was analyzed. Results Among 232 cases with histologically confirmed colon cancer, there were 56 cases were pathologically diagnosed as synchronous primary malignant neoplasms. Fifty-three cases were true positive cases diagnosed by18F-FDG PET/CT. There was 4 false positive cases, of which 1 case was polyps, 1 case was adenoma（precancerous lesions）, 1 case was thyroid adenoma, and one was pulmonary inflammatory pseudotumor. There were 3 false negative cases, including 1 case of gastric antrum ring cell carcinoma, 1 case of renal clear cell carcinoma, and 1 case of primary hepatocellular carcinoma which was diagnosed as colon cancer liver metastasis by18F-FDG PET/CT imaging. The sensitivity, specificity, and accuracy of18F-FDG PET/CT imaging were 94.64%, 97.58%, and 96.83% respectively. There was no statistically significant difference between pathological and PET/CT diagnosis（P≈1.000）, and showed high consistency between the two diagnostic methods（kappa value 0.917, P =0.000）. Conclusion18F-FDG PET/CT can effectively detect unexpected synchronous primary malignant neoplasms in patients with colon cancer.

关 键 词：结肠癌 重复癌 正电子发射体层成像 体层摄影术 X线计算机 

分 类 号：R739.41[医药卫生—肿瘤]