早期18F-FDGPET／CT显像在结直肠癌术后再分期中的临床价值  

Value of early postoperative ^(18)F-FDG PET/CT in restaging of the colorectal carcinoma

作　　者：付蔷[1,2,3] 徐文贵[1,2,3] 于筱舟 刘建井[1,2,3] 李小凤[1,2,3] 

机构地区：[1]天津医科大学肿瘤医院分子影像与核医学诊疗科,国家肿瘤临床医学研究中心 [2]天津市"肿瘤防治"重点实验室 [3]天津市恶性肿瘤临床医学研究中心,天津300060

出　　处：《天津医科大学学报》2017年第1期38-40,共3页Journal of Tianjin Medical University

摘　　要：目的:评价术后早期^(18)F-FDG PET/CT显像在结直肠癌再分期中的临床价值。方法:回顾性分析术前分期明确且行局部结直肠癌切除手术、术后行^(18)F-FDG PET/CT显像的结直肠癌患者46例,根据显像结果对其进行再分期,分析分期改变率,并通过χ2检验和秩和检验分析再分期影响因素。结果:46例患者中共14例(30.4%)出现病理性^(18)F-FDG的摄取,其中13例证实为恶性病灶且分期上升,肝脏转移7例(53.8%),外周淋巴结转移5例(38.5%),腹膜转移1例(7.7%),意外发现其他类型肿瘤2例(15.4%),1例证实为淋巴结炎性反应性增生。PET/CT在诊断结直肠癌远处转移方面的灵敏度为100%,特异度为97.3%,阳性预测率为92.9%。秩和检验结果表明,相对于较早期I/II期结直肠癌病人而言,术后早期^(18)F-FDG PET/CT显像对于晚期III期结直肠癌病人再分期改变率较高,χ2检验结果显示年龄、性别、原发部位对于术后再分期无显著影响。结论:术后早期^(18)F-FDG PET/CT显像在结直肠癌再分期中具有重要的临床价值,尤其是对于晚期(III期)病人意义更为明显。Objective： To evaluate 18F-FDG PET/CT in the diagnosis of restaging for colorectal carcinoma. Methods： Forty six cases, of postoperative colorectal carcinoma examined by 18F-FDG PET/CT imaging were reviewed to restage and analyze the influence factors by Chi-squared test and Kruskal-Wallis test. Results： In all cases, pathological 18F-FDG uptake was observed in 14 （30.4%）. of these,13 were upstaged with true-positive metastatic disease in distant organs after further workup （the liver in 7 cases, lymph node in 5 cases, peritoneum in one case） and one case had false-positive finding. The sensitivity and specificity of PET/CT for detecting metastatic disease were 100% and 97.3% respectively, the positive predictive value was 92.9%. The Kruskal-Wallis univariate analysis showed that patients in stage III had more risk than the patients in stage Ⅰ/Ⅱ （P 〈0.05）. The Chi-square test showed that age, sex and tumor location were not significantly associated with upstaging. Conclusion： The early postoperative 18F-FDG PET/CT have an important role in restaging of the colorectal carcinoma esDeciallv in the patients in stage Ⅲ.

关 键 词：结直肠癌 18SF-FDGPET/CT显像 再分期 

分 类 号：R735.3[医药卫生—肿瘤]