^18F-FDG PET/CT在不明原发灶肿瘤中的临床应用价值  

Clinical value of ^18F-FDG PET/CT in cancer of unknown primary

作　　者：金民山 张俊[1] 姜一逸 戴春雷[1] 梁劲峰[1] 

机构地区：[1]江苏省泰州市人民医院核医学科,225300

出　　处：《国际放射医学核医学杂志》2017年第2期94-97,149,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨^18F-FDG PET/CT全身显像在不明原发灶肿瘤（CUP）诊断中的临床应用价值.方法 回顾分析46例于2015年2月至2016年6月在我院行常规检查未能发现肿瘤原发灶而进一步行^18F-FDG PET/CT全身显像查找肿瘤原发灶的转移性肿瘤患者的资料.PET/CT图像分析采用视觉及半定量分析方法.通过病理活检和（或）临床综合诊断、临床随访对结果进行评价.结果 46例患者中,^18F-FDG PET/CT显像找到原发肿瘤33例,均经过病理活检及临床随访证实;13例未发现原发病灶.^18F-FDG PET/CT对不明肿瘤原发灶的检出率为71.7％（33/46）,其中阳性患者中淋巴瘤3例、胃癌2例、食管癌4例、卵巢癌3例、肺癌14例、肝癌2例、尿路上皮癌1例、鼻咽癌2例、多发性骨髓瘤1例、降结肠癌1例.转移方式主要有淋巴结转移32例、骨转移20例、肝转移13例、肺转移9例、胸膜腹膜转移5例、肾上腺转移3例、脑转移4例、皮下转移3例、心包膜转移1例.结论 ^18F-FDG PET/CT全身显像对CUP的检出率显著优于一般常规检查,对临床指导治疗有着重要意义.Objective To evaluate the clinical value of ^18F-FDG PET/CT whole-body imaging in the manage-ment of cancer of unknown prinary（CUP）.Methods From February 2015 to June 2016,46 CUP patients were analyzed retrospectively in Taizhou People＇s Hospital.They underwent ^18F-FDG PET/CT imaging to detect their primary tumors that had not been detected through routine examinations.Visual and semiquantitative analyses were then employed to analyze the PET/CT images.The results were assessed on the basis of the pathological results,comprehensive clinical diagnoses,and clinical follow-ups.Results Of the 46 patients,33 had primary tumors,which were detected through ^18F-FDG PET/CT imaging and further confirmed by pathology or clinical follow-up.Meanwhile,the primary tumors in 13 patients were not characterized.The CUP detection rate of the 18F-FDG PET/CT was 71.7% （33/46）.Of the 33 patients with detected CUPs,3 had lymphoma,2 had gastric cancer,4 had esophageal cancer,3 had oophoroma,14 had lung cancer,2 had liver cancer,1 had urinary tract epithelial cancer,2 had nasopharyngeal carcinoma,1 had multiple myeloma,and 1 had colon cancer.The modes of tumor metastasis included lymphatic metastasis in 32 cases,bone metastasis in 20 cases,liver metastasis in 13 cases,lung metastasis in 9 cases,pleural and peritoneal metastasis in 5 cases,adrenal metastasis in 3 cases,brain metastasis in 4 cases,subcutaneous metastasis in 3 cases,and pericardium metastasis in 1 case.Conclusions The ^18F-FDG PET/CT outperforms ordinary routine examinations in terms of CUP detection.Thus,^18F-FDG PET/CT possesses significant importance to clinical management.

关 键 词：氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 不明原发灶肿瘤 

分 类 号：R730.44[医药卫生—肿瘤]