^(18)F-FDG PET扫描在结直肠癌中的临床应用价值

Clinical applications of ^(18)F- FDG PET in colorectal cancer

目的评价18F-FDGPET在结直肠癌中的临床应用。方法对63例患者作了18F-FDGPET检查,PET显像的结果与临床诊断作比较以评价PET显像的诊断准确性及临床价值。其中22例疑为结肠癌术后复发或转移中15例患者作了CT检查,以评价PET检查对结直肠癌术后复发或转移的敏感性和准确度。结果41例疑似为结直肠癌的患者确诊为结直肠腺癌37例,息肉4例,PET的诊断准确率92.7%、灵敏度100%,特异度25.0%。PET对肝转移诊断准确度85.4%,灵敏度75.0%,特异度93.5%。PET对腹腔淋巴结转移灵敏度63.0%,特异度86.4%,准确度75.0%。对22例结肠癌术疑为结直肠癌复发或转移的患者,PET在检测肿瘤转移或复发的灵敏度92.8%,明显高于CT63.6%。特异度PET为42.9%,低于CT75.0%,准确度两者相似(76.2%,66.7%)。结论PET检查对可疑的结直肠癌有较高的临床诊断价值,腹腔淋巴结转移灵敏度高,有利于制定手术方案。另外PET较CT对可疑的直肠癌术后复发和转移更敏感,并有助于复发肿瘤的定位和确定再次手术。

[Objectives] To evaluate the effect of 18-F-FDG PET （Fluorodeoxyglucose position emission tomography） in diagnoses of Colorectal cancer. [Methods] Taking ^18F-FDG PET on 63 suspicions of Colorectal cancer. By comparing the result of PET and the clinical diagnosis, we fund that the diagnoses from PET were more accurate and valuable. Among those 63 patients, 22 was suspicious of recrudescence or metastasis of Colorectal cancer after operation and 15 of this 22 took computed tomography （CT）. Thus, we could evaluate the sensitivity and accuracy in diagnosis by PET. [Results] Among those 41 patients, 37 were concluded to suffered carcinoma and the other four were suffered polyp. The accuracy of the diagnoses of Colorectal cancer by PET was 92.7%, the sensitivity was 100% and the specificity was 25%. While the accuracy in diagnosis of the metastasis of liver cancer by PET was 85.4%, sensitivity was 75% and specificity was 93.5%. As to diagnosis in metastasis of celiac lymph node, the accuracy was 75% with 63% sensitivity and 86.4% specificity. Among those 22 suspicious patients of recrudescence or metastasis of Colon cancer after operation, PET diagnosis had 92.8% sensitivity, which is higher than CT diagnosis＇ s 63.6%, 42.9% in specificity, which is lower than CT＇s 75% and 76.2% in accuracy compared with CT＇s 66.7%. [Conclusion] PET＇s diagnosis is meaningful to make operation plan because it is more valuable in diagnosing Colorectal cancer and its metastasis, more sensitive in metastasis of celiac lymph node. Additionally, compared with CT, PET is more sensitive in diagnosing recrudescence or metastasis of Colorectal cancer after operation and helpful to locate the recrudescencent cancer and re-operate. The result of PET is more meaningful and helpful for sufferer to decide whether needs operation.