^(18)F-FDGPET/CT联合甲胎蛋白在原发性肝癌诊断与复发监测中的应用研究

AFP-combined ^(18)F-FDG PET/CT detection of PHC and its recurrence

研究了18F-FDGPET/CT与甲胎蛋白(AFP)对原发性肝癌(PLC)的诊断与复发监测效能,并初步探讨两者联检的意义。分析了63例临床或病理证实PLC患者的72次全身PET/CT显像结果,根据每位患者的近期AFP水平,分为AFP阳性组和阴性组,结合临床随访及病理结果,独立统计各组灵敏度(Se)和阳性预测值(PPV)。单独18F-FDGPET的Se为73.24%,PPV为98.11%;单独AFP的Se为73.24%,PPV为100.00%。但在AFP阳性组,PET的Se和PPV被明显提高,分别为80.77%、100.00%;相反在AFP阴性组两者则被降低,分别为52.63%、90.91%。另外,63例病人中,有59例检出共98处器官转移。本研究结果表明:①PET/CT对AFP在PLC诊断和复发监测中有显著的辅助作用,特别是AFP阳性病例;②PET/CT在PLC转移灶的检出作用好于单独PET或CT,对临床PLC分期及预后有较大作用。

The paper is to analyze the value of 1SF-FDG PET/CT, which is combined with alpha-fetoprotein （AFP）, in detecting primary hepatic carcinoma （PLC） and monitoring its recurrence, lSF-FDG PET/CT images of 63 patients （72 studies） with PLC confirmed by histology or clinic were retrospectively analyzed. According to serum AFP, they were divided into positive and negative group. By the results of histology and follow-up, the diagnostic values were calculated respectively. The sensitivity and positive predictive value of PET/CT was 73.24% and 98.11%,vs AFP 73.24% and 100.00% respectively, in detection and monitoring recurrence of PLC. In AFP positive group, sensitivity and positive predictive value for PET were higher than they were in AFP negative group, （80.77% and 100.00% vs 52.63% and 90.91%, respectively）. In addition, 98 metastasis were discovered in 59 cases of the 63 patients. It is concluded that ^18F-FDG PET/CT is a outstanding aid to AFP in detection PLC and in monitoring recurrence of HCC, especially in cases with abnormal serum AFP levels, and.PET/CT is a more powerful method in detecting metastasis of PLC than PET or CT. And in tumor staging and predict prognosis, PET/CT appears to be a very useful method.