^(18)FDG-PET对大肠癌分期、再分期诊断的价值

The Value of ^(18)FDG-PET in Staging and Restaging of Colorectal Cancer

目的:评价18FDG-PET(18氟标记脱氧葡萄糖-正电子发射断层扫描)对大肠癌分期及术后再分期的价值。方法:对24例经肠镜检查初步诊断为直肠、结肠癌的患者行全身18FDG-PET检查,并在1～2W内完成手术及病理诊断。大肠癌术后18FDG-PET随访56例。结果:24例病理证实为大肠癌,23例局部18FDG摄取增高,SUVmax=7.09±3.26,2.98～12.2(SUV,Standarduptakevalue)。18FDG-PET对于肿瘤原发病灶诊断准确率为95%(23/24)。假阴性1例。单纯局部(主要为第1站)淋巴结转移8例(灵敏度8/16,50%),远处转移8例。改变33%(8/24)的患者治疗方案。56例随访病例中30例PET显示阴性,其中5例随访2年后复发,准确率83.4%。26例发现局部和/或多发转移,其中颈部淋巴结转移8例;肺及纵隔转移4例;肝转移7例;腹腔淋巴结转移11例;吻合口局部复发12例,骨转移11例。结论:18FDG-PET对大肠癌的分期和术后的再分期诊断有较高价值。

To appraise the value of FDG-PET in the staging and restaging diagnosis of colorectal carcinoma. Methods： A total of 24 patients with potentially colorectal carcinoma and other 56 patients followed up were included in this study. A whole-body FDG-PET was conducted and evaluated for increased focal uptake. Accuracy was determined by comparion of PET with surgical staging. Results： The primary tumor was visualized in 95% with PET. Distant metastases were found in six patients （100%）. For simple regional lymph nodes the sensitivity was 50%, the specificity was 100%. 33% of patients were facilitated in the treatment planning. In the 56 patients followed up, PET negative were showed in 30 and relapse in 5 cases 2 years after follow up, with an accuracy of 83.4%. The generalized single and/or multiple metastases were found in 28 patients, clavicle lymph metastasis in 8, lung metastasis in 4, liver metastasis in 7, abdominal lymph metastasis in 11, local recurrence in 12 and bone metastasis in 11. Conclusion： FDG-PET may be useful in the diagnosis and staging of colorectal carcinoma and following-up patients with recurrent colorectal carcinoma.