18F-FDG PET/CT显像在无症状健康人群中癌症筛查的临床价值  

作　　者：任东栋 孙达[2] 任春玲 

机构地区：[1]浙江省宁波明州医院,315100 [2]浙江大学医学院附属第二医院,310009

出　　处：《浙江临床医学》2018年第5期839-841,共3页Zhejiang Clinical Medical Journal

摘　　要：目的 探讨无症状健康人群用18F-FDG PET/CT显像进行癌症筛查的临床价值.方法 回顾性分析611例以癌症筛查为目的行全身18F-FDG PET/CT显像受检者的资料,定性和半定量分析PET及CT图像,并与随访结果进行比较.对有疑问者随访至少〉8年,恶性肿瘤均经手术病理结果证实.结果 611例受检者中PET/CT示FDG代谢异常增高者162例,高度怀疑恶性病灶14例,其中4例经手术病理证实为恶性肿瘤,分别为结肠恶性间质瘤、肺癌、甲状腺癌及乳腺癌,其余10例经手术病理检查和或临床随访确认为良性病变.另外假阴性1例,为肝细胞肝癌.结论 18F-FDG PET/CT显像具有发现各种不同早期癌症的优势,为治疗争取到宝贵时间.假阳性和假阴性是癌症筛查中不可忽视的问题,将PET/CT与增强CT、MRI、B超、肿瘤标志物等检查结合可以最大限度地减少假阳性和假阴性所导致的误诊和漏诊,但部分受检者仍需要通过病理学确诊.Objective To investigate the clinical value of ISF-FDG PET/CT for cancer screening in asympmmatic healthy populations. Methods 611 asyrnptomatic healthy cases without specific medical histories underwent whole-body ISF-FDG PET/CT scan in our PET/CT center were retrospective analyzed. The reconstructed images of PET and CT were analyzed qualitatively and semi-quantitatively. The diagnostic value was deten＇nined according to the results of surgical pathology or clinical follow-ups. The suspected cases were followed up for at least 8 years. Results Of 611 cases, abnormal focal hypermetabolic areas were found in 162 cases. 14 cases of them were doubted as malignancy and 4 cases were confirmed as malignant tumors by surgical pathology.4 cases included one malignant stromal tumor of colon, one lung cancer, one thyroid cancer and one breast cancer. The other 10 cases were confirmed as benign lesions by surgical pathology and/or clinical follow-ups. In addition, 1 case of false negative was hepatocellular carcinoma. Conclusion 18F-FDG PET/CT has the potential to detect a wide variety of cancers in early stages. PET/CT combining with enhanced CT, MRI, ultrasound and tumor markers can reduce false-positive and false-negative results. But the final confirmation of some cases still depends on pathological examinations.

关 键 词：癌症筛查 恶性肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R739.41[医药卫生—肿瘤]