18F-FDG PET/CT在胃癌诊断中应用价值  

Value of 18F-FDG PET/CT in diagnosis of gastric cancer

作　　者：王凯瑞 赵多文 王嘉彤 郭丽[1] 杨海燕[1] 李涛[2] 赵倩[3] WANG Kai-rui;ZHAO Duo-wen;WANG Jia-tong;GUO Li;YANG Hai-yan;LI Tao;ZHAO Qian(Graduate School of Ningxria Medical University,Yinchuan 750004,P.R.China;General Hospital of Ningxia Medical Universily,Yinchuan 750004,P.R.China)

机构地区：[1]宁夏医科大学研究生院,宁夏银川750004 [2]宁夏医科大学总医院肿瘤外二科,宁夏银川750004 [3]宁夏医科大学总医院核医学科,宁夏银川750004

出　　处：《中华肿瘤防治杂志》2020年第7期554-558,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(81660500);宁夏医科大学国内一流建设学科临床医学资助项目(NXYLXK2017A05)。

摘　　要：目的氟代脱氧葡萄糖正电子发射计算机断层显像(18F-fluorodeoxyglucose positron emission tomography/computer tomography,18F-FDG PET/CT)检查对胃癌术后肿瘤的复发和转移有着重要作用,但对胃癌患者术前的应用价值一直以来有待明确。本研究探讨18F-FDG PET/CT对于未接受任何治疗的胃癌患者其诊断的应用价值。方法回顾性分析宁夏医科大学总医院2012-05-08-2018-12-24临床初诊为胃部病变的79例患者临床资料,并于治疗前接受18F-FDG PET/CT检查。根据患者相关的病历资料,包括性别、年龄、肿瘤部位、分化程度、病理分期等因素分别进行分组,再对各组患者18F-FDG PET/CT检查结果中的最大标准摄取值(maximum standard uptake value,SUVmax)进行比对,应用相关统计学软件进行数据分析。结果经病理学确诊,79例胃部病变患者中胃腺癌60例,原发性胃淋巴瘤17例,慢性萎缩性胃炎2例。原发性胃淋巴瘤组的SUVmax为18.39±8.85,胃腺癌组的SUVmax为8.31±5.64,两者之间的差异有统计学意义,t=4.45,P<0.05,说明SUVmax在术前鉴别两种疾病时能够提供有效的诊断价值。胃癌患者术后病理,Ⅰ期SUVmax为3.28±1.22,Ⅱ期SUVmax为13.49±9.68,Ⅲ期SUVmax为8.03±3.61,Ⅳ期SUVmax为10.20±1.91,各组之间差异有统计学意义,F=12.56,P<0.05。从而证实了在胃癌术后病理分期方面,治疗前行18F-FDG PET/CT可以为此提供可靠的半定量依据。结论18F-FDG PET/CT能够在胃癌和原发性胃淋巴瘤的鉴别以及胃癌术后病理分期等方面提供重要的诊断价值,从而更好的指导临床治疗。OBJECTIVE 18F-FDG PET/CT plays an important role in the recurrence and metastasis of gastric cancer after surgery,but the application value of patients with preoperative gastric cancer has yet to be clarified.This article aimed to study the diagnostic value of 18F-FDG PET/CT in patients with gastric cancer who had not received any treatment.METHODS A retrospective analysis was performed on the patients who were admitted to the General Hospital of Ningxia Medical University from May 8,2012 to December 24,2018.These patients were initially diagnosed as gastric cancer and underwent 18F-FDG PET/CT before treatment.Collecting the relevant medical records of patients,including gender,age,tumor site,degree of differentiation,pathological stage,etc.Groups were divided according to different factors,and SUVmaxof patients were analyzed statistically in each group.RESULTS In 79 patients initially diagnosed with gastric cancer,60 cases of gastric adenocarcinoma,17 cases of primary gastric lymphoma and 2 cases of chronic atrophic gastritis were confirmed by pathological results.The SUVmaxof primary gastric lymphoma group was 18.39±8.85,while that of gastric adenocarcinoma group was 8.31±5.64,the difference was statistically significant(t=4.45,P<0.05).This indicated that SUVmaxcould provide effective diagnostic value in the preoperative differentiation of two diseases.In gastric cancer patients with postoperative pathology,SUVmaxof phaseⅠwas 3.28±1.22,SUVmaxof phaseⅡwas 13.49±9.68,and SUVmaxof phaseⅢwas 8.03±3.61,and SUVmaxof phaseⅣwas 10.20±1.91,the difference was statistically significant(F=12.56,P<0.05).Thus,it was confirmed that in terms of postoperative pathological staging of gastric cancer,18F-FDG PET/CT before treatment could provide the reliable semi-quantitative basis.CONCLUSION 18F-FDG PET/CT can provide important diagnostic value for the differential diagnosis between gastric cancer and primary gastric lymphoma as well as postoperative pathological staging of gastric cancer which can guide better for

关 键 词：胃癌 原发性胃淋巴瘤 PET/CT 诊断 病理分期 

分 类 号：R735.2[医药卫生—肿瘤]