^(18)F-脱氧葡萄糖PET-CT检测食管癌治疗后复发与转移的应用价值

Value of ^(18)FDG PET-CT in detecting recurrence and metastasis in post-treatment esophageal carcinoma

目的评价^(18)F-脱氧葡萄糖(^(18)FDG)PET-CT对食管癌治疗后复发及转移的临床应用价值。方法治疗后怀疑肿瘤残留、复发或转移而行PET-CT扫描的食管癌37例,回顾性分析其临床资料,根据细胞学、病理或随访结果分析PET-CT的检测结果。结果31例患者最终确定复发转移灶46处,PET-CT对全部病灶的诊断敏感性、特异性和准确性分别为93．5%(43/46)、76．9%(20/26)和87．5%(63/72),在术后吻合口和肺门淋巴结的检测中各出现2例假阳性,使总体特异性降低,特别是局部复发仅50%(3/6)。复发转移(31例)及随访期内死亡的病例(26例)SUV高于对照组(t=2．40、3．04,P=0．022、0．004)。结论尽管对局部复发的诊断特异性较低,但^(18)FDG PET-CT仍不失为探测食管癌治疗后复发转移的有效工具,SUV可为预后评估提供重要参考价值。

Objective To evaluate the clinical value of ^18-fluoro-deoxyglucose positron emission tomography-CT（ ^18FDG PET-CT） for recurrence and metastasis in treated esophageal carcinoma （EC）. Methods A retrospective study is done on 37 previously treated EC patients who underwent PET-CT scans to detect recurrent or metastatic lesions. The diagnostic accuracy of ^18FDG PET-CT was assessed with the help of pathological finding as well as clinical or follow-up data. Results Fourty-six sites of recurrence were finally confirmed in 37 patients by cytology, pathology or follow-up data. The sensitivity, specificity and accuracy of PET-CT in detecting recurrence of all sites were 93.5% （43/46） , 76.9% （20/26） and 87.5% （63/72） , respectively. Two false-positive findings were found both at the anastomosis and hilar nodes, which caused the decrease in the overall specificity, especially that locally. The analysis of standard uptake value （SUV） demonstrated that patients with recurrence or who died during follow-up had higher SUVs compared with the control group. Condusions ^18FDG PET-CT is highly effective in detecting recurrence in previously treated EC patients despite the low specificity at local sites. The analysis of stardard uptake value（SUV） provides incremental value in prognosis for this patient cohart.