^(18)F-FDG PET/CT在食管癌术后吻合口复发及远处转移中的诊断价值  

Diagnostic Value of^(18)F-FDG PET/CT in Postoperative Anastomotic Recurrence and Distant Metastasis of Esophageal Cancer

作　　者：朱蕻潮 黄婧 陶维静[1] 王书中[1] 谭维琴[1] 谷彪[3] 陈丽娟[4] ZHU Hongchao;HUANG Jing;TAO Weijing(The Affiliated Huaian No.1 People′s Hospital of NanJing Medical University,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院核医学科,223300 [2]南京医科大学附属淮安第一医院放疗科,223300 [3]南京医科大学附属淮安第一医院胸外科,223300 [4]南京医科大学附属淮安第一医院临床药学室,223300

出　　处：《医学研究杂志》2023年第5期153-157,93,共6页Journal of Medical Research

基　　金：江苏省淮安市自然科学研究计划项目(HAB202026);南京医科大学科技发展基金资助项目(NMUB2020153)。

摘　　要：目的探讨^(18)F-FDG PET/CT在食管癌术后吻合口复发诊断中的价值,并观察发生远处转移的情况。方法回顾性分析2019年1月~2021年6月在笔者医院行^(18)F-FDG PET/CT检查的67例食管癌术后患者的临床资料。所有患者^(18)F-FDG PET/CT检查均提示吻合口增厚伴FDG代谢增高,测量吻合口最大厚度、CT值、FDG代谢的最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)。吻合口病灶均于患者检查后2周内经病理组织学确诊,其中观察组为吻合口复发患者,对照组为吻合口良性增厚患者。利用t检验分析两组术后吻合口病灶各参数的变化情况,应用ROC曲线评估各参数诊断食管癌术后吻合口复发的特异性及敏感度。评价^(18)F-FDG PET/CT在两组术后患者发生远处转移诊断中的价值。结果31例患者吻合口经病理诊断为肿瘤复发(观察组),36例患者吻合口经病理诊断为良性增厚(对照组)。观察组SUVmax、吻合口厚度及SUVmean(10.01±2.15、^(18).10±3.60、5.83±1.59)均大于对照组(6.31±1.46、12.78±1.74、4.41±1.44),差异均有统计学意义(P<0.01)。SUVmax及吻合口厚度在ROC曲线下面积分别为0.919、0.898(P均<0.01),在所有参数中,SUVmax的诊断价值最高。观察组发生远处转移的发生率(38.71%)高于对照组(16.67%),差异有统计学意义(χ^(2)=5.23,P=0.022)。结论可凭借参数SUVmax及吻合口最大厚度的研究对食管癌患者术后吻合口复发情况进行预判;术后吻合口复发患者更易发生远处转移,^(18)F-FDG PET/CT能对术后转移情况进行全身评价、尤其在传统影像学显示阴性的组织内可以发现新的转移灶,能为临床指导治疗方案的选择提供帮助。Objective To explore the value of^(18)F-FDG PET/CT in the diagnosis of anastomotic recurrence after esophageal cancer surgery,and to observe the occurrence of distant metastasis.Methods Data of 67 patients with esophageal cancer who underwent^(18)F-FDG PET/CT examinations in our hospital from January 2019 to June 2021 were retrospectively analyzed.^(18)F-FDG PET/CT examination of all patients showed anastomotic thickening accompanied by increased FDG metabolism.We measured the thickness of anastomotic lesions,CT value,SUVmax,and SUVmean.Anastomotic lesions were diagnosed by histopathology within 2 weeks after examination.The observation group was patients with recurrence of anastomotic tumors,and the control group was patients with benign anastomotic thickening.We used t test to analyze the changes of various parameters of anastomotic lesions between two groups.The parameters were analyzed by the receiver operating characteristic(ROC)curve in order to assess the sensitivity and specificity of the anastomotic recurrence.We evaluated the value of^(18)F-FDG PET/CT in the diagnosis of distant metastases in the two groups.Results 31 patients were diagnosed as tumor recurrence(observation group),and 36 patients were diagnosed as benign thickening(control group).Parameters SUVmax,anastomotic thickness and SUVmean between the observation group(10.01±2.15,^(18).10±3.60,5.83±1.59)and the control group(6.31±1.46,12.78±1.74,4.41±1.44)were statistically significant(P<0.01).The area under the ROC curve of SUVmax and anastomotic thickness were 0.919 and 0.898,respectively(P<0.01).SUVmax had the best diagnostic value in all parameters.The incidence of distant metastasis in the observation group was higher than that in the control group(38.71%vs 16.67%),and the difference was statistically significant(χ^(2)=5.23,P=0.022).Conclusion Parameters SUVmax and anastomotic thickness can be used to predict the recurrence.Patients with anastomotic recurrence are more likely to develop distant metastasis.^(18)F-FDG PET/CT can be used

关 键 词：食管癌 吻合口 ^(18)F-FDG PET/CT 代谢参数 ROC曲线 

分 类 号：R735.1[医药卫生—肿瘤]