^18F-FDG PET/CT在胰腺癌分期中的价值  

Value of ^18F-FDG PET/CT in staging of pancreatic cancer

作　　者：于江媛[1] 李囡[1] 范洋[1] 陈菩芸 张岩[1] 赵伟[1] 杨志[1] 

机构地区：[1]恶性肿瘤发病机制及转化研究教育部重点实验室、北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科,100142

出　　处：《中华核医学与分子影像杂志》2017年第8期456-459,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 探讨^18F-FDG PET/CT在胰腺癌诊断与分期中的作用和价值.方法 回顾性分析2010年6月至2015年8月77例（男44例,女33例,年龄36~83岁）胰腺癌初诊患者资料,所有患者PET/CT检查前均未接受相关治疗,且在检查后4周内完成手术或活组织检查,均具备病理学结果.两样本均数的比较采用两样本t检验.绘制ROC曲线并计算AUC,选取诊断界值.结果 约94.8%（73/77）的胰腺癌原发病灶高摄取^18F-FDG,其放射性分布水平明显高于周围胰腺实质（即SUVmax〉3.0）, SUVmax为2.4~13.4（平均6.2±2.4）.原发病灶短径≤2.0 cm组与短径〉2.0 cm组间SUVmax的差异具有统计学意义（t=-2.661, P〈0.05）.46例患者进行了淋巴结切除或清扫,平均清扫淋巴结（13.8±9.2）枚,其中56.5%（26/46）患者经病理确认淋巴结转移.当区域淋巴结短径为0.45 cm时,灵敏度为84.8%（39/46）,特异性为65.2%（30/46）,AUC为0.788;当区域淋巴结SUVmax为2.05时,灵敏度为54.3%（25/46）,特异性为80.4%（37/46）,AUC为0.759.有18.2%（14/77）的患者经PET/CT额外发现多处转移,改变了临床分期及治疗方案.结论 PET/CT作为一项全身检查,虽然在N分期方面不具备显著优势,但其对M分期的准确评估使相当一部分患者避免了不必要的手术,更改了治疗方案,获得了最优化治疗.Objective To evaluate the value of ^18F-FDG PET/CT in tumor staging in patients with pancreatic cancer.Methods A total 77 patients （from June 2010 to August 2015;44 males, 33 females, age range 36-83 years） who underwent ^18F-FDG PET/CT examination for pancreatic cancer and confirmed with pathology were enrolled in this retrospective study.All patients had not been treated before the PET/CT scanning and received surgery or biopsy 4 weeks after the scanning.Two-sample t test and ROC curve analysis were used for data analysis.Results ^18F-FDG uptake was higher in 94.8%（73/77） of pancreatic lesions than that in normal pancreatic tissue.The range of SUVmax of pancreatic lesions was 2.4-13.4（mean： 6.2±2.4）.SUVmax of patients with smaller primary lesion （minor axis≤2.0 cm） was significantly lower than that of larger lesion group （minor axis 〉2.0 cm;t=-2.661, P〈0.05）.A total of 46 patients underwent lymph node excision, and the mean number of excised lymph nodes per patient was 13.8±9.2.About 56.5%（26/46）cases with lymph nodes metastases were confirmed with pathology.When the cut-off value of minor axis of regional lymph nodes was 0.45 cm, ROC curve showed that the sensitivity, specificity and AUC were 84.8%（39/46）, 65.2%（30/46） and 0.788, respectively.When the cut-off value of SUVmax of regional lymph nodes was 2.05, the sensitivity, specificity and AUC were 54.3%（25/46）, 80.4%（37/46） and 0.759, respectively.^18F-FDG PET/CT changed 18.2%（14/77）of patients′ treatment plan.Conclusions ^18F-FDG PET/CT is a useful tool in pancreatic cancer staging.Though ^18F-FDG PET/CT has no significant advantages in N-staging, it really helps to make a more accurate M-staging for clinical decision.

关 键 词：胰腺肿瘤 肿瘤分期 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R730.44[医药卫生—肿瘤]