18F-FDG PET/CT在睾丸非精原细胞瘤化疗后腹膜后肿瘤残留中的判断价值  

The value of 18 fluorodeoxyglucose positron emission tomograhy in predicting post-chemotherapy retroperitoneal lymph nodes involvement in nonseminomatous germ cell tumors of testis

作　　者：马金超 王硕[1] 杜鹏[1] 杨勇[1] MA Jinchao;WANG Shuo;DU Peng;YANG Yong(Urological Department,Peking University Cancer Hospital&Institute/Key Laboratory of Carcinogenesis and Translational Research(Mninistry of Education),Bejjing 100142,China)

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

出　　处：《河南大学学报（医学版）》2021年第1期44-48,共5页Journal of Henan University:Medical Science

基　　金：首都临床特色应用研究项目(Z18110700170000)。

摘　　要：[目的]探讨利用18F-FDG PET/CT在判断睾丸非精原细胞瘤患者化疗后腹膜后转移病灶残留的可靠性。[方法]回顾性分析了2018年5月至2019年5月北京大学肿瘤医院5例睾丸非精原细胞生殖肿瘤伴腹膜后淋巴结转移患者,所有患者进行BEP和/或VIP化疗后18F-FDG PET/CT检查均提示腹膜后存在活性肿瘤病灶,之后行开放腹膜后淋巴结清扫术,术后病理与术前PET/CT结果进行比较。[结果]5例患者平均年龄(33.4±11.17)岁,5例患者化疗后腹膜后淋巴结大小均出现不同程度的降低[(3.22±0.77)cm vs(1.72±0.49)cm,P=0.006],腹膜后淋巴结清扫(RPLND)前18FFDG PET/CT腹膜后病灶最大摂取率(SUVmax)较化疗前出现一定程度下降(8.09±5.08 vs 3.80±1.86,P=0.116),RPLND术后病理结果提示:3例患者腹膜后未发现明确转移病灶,1例患者术后病理回报为成熟畸胎瘤,1例患者为胚胎癌合并卵黄囊瘤成分,18F-FDG PET/CT判断肿瘤残留病灶假阳性率为60%,准确率为40%。[结论]对于睾丸非精原生殖细胞瘤化疗后的患者,单纯利用18F-FDG PET结果判断肿瘤病灶是否残留的准确性较低。[Objective]To investigate whether-18 fluorodeoxyglucose positron emission tomography(18 F-FDG-PET)could be used as a reliable method to identify post-chemotherapy retroperitoneal lymph node(RPLN)involvement in none-seminoma germ cell tumors(NSCT).[Methods]Since May 2018 to May 2019,five NGCE patients with RPLN were enrolled,18F-FDG PET/CT were performed after BEP and/or VIP chemotherapy,retroperitoneal tumor dissection was performed to confirm the pathology.[Results]Mean age was 33.4±11.17 years,the maximum diameter of RPLN significantly decreased after-chemotherapy[(3.22±0.77)cm vs(1.72±0.49)cm,P=0.006)1,and the SUVmax also decreased after-chemotherapy(8.1±5.12 vs 3.80±1.86,P=0.116).No tumors were found in 3 men confirmed by pathology,while the other two were found tumors,one was mature teratoma,the other one was Yolk Sac tumor and embryonal carcinoma,false positive rate of 18F-FDG PET/CT was 60%,accuracy rate was 40%.[Conclusion]The result of 18F-FDG/PET will be influenced by many factors,it seems not to be a reliable method detecting RPLN involvement in NSCT of the testisfollowing chemotherapy alone.

关 键 词：PET/CT 非精原生殖细胞瘤 化疗 病灶残留 

分 类 号：R737[医药卫生—肿瘤]