^18F-FDG PET/CT食管异常代谢灶诊断食管恶性病变的价值

Value of esophageal abnormal metabolism lesions of ^(18)F-FDG PET/CT for the clinical diagnosis of esophageal malignancy

目的评价18F-FDGPET/CT发现食管异常代谢灶对临床诊断食管恶性病变的价值。方法18F-FDGPET/CT检查发现食管(包括贲门)异常代谢灶患者67例,按照PET/CT结果分为弱阳性组(16例)、一般阳性组(24例)与强阳性组(27例)。将三组病例的PET/CT结果与病理或临床随访结果进行对照。结果PET/CT弱阳性组中恶性病变7例(43.75%),一般阳性组中恶性病变22例(91.67%),强阳性组中恶性病变26例(96.30%)。整体上三组之间差异存在统计学意义(χ2=18.732,P<0.05)。一般阳性组与强阳性组之间差异无统计学意义(χ2=0.011,P=0.916>0.017),弱阳性组与一般阳性组之间差异有统计学意义(χ2=8.783,P=0.003<0.05),弱阳性组与强阳性组之间存在统计学差异(χ2=12.738,P<0.017)。结论PET/CT一般阳性组与强阳性组的恶性病变发生率均很高,二者无显著差异;弱阳性组恶性病变发生率达43.75%,临床对此应予足够重视。

Objective To estimate the value of ^18F-FDG PET/CT in different groups＇ abnormal metabolism lesions of esophagus （including gastric cardia） for the clinical diagnosis of esophageal malignancy. Methods Sixty-seven patients with esophageal （including gastric cardia） abnormal metabolism lesions of ^18F-FDG PET/CT were divided into 3 groups according to the results of PET/CT： weak positive group （16 cases）, middle positive group （24 cases） and strong positive group （27 cases）. With the contrast of PET/CT and pathology or clinical follow-up, chi-square test was performed to judge if there was statistical difference in each two groups among these three groups. Results Malignancies was diagnosed in 7 cases （43.75%） in weakly positive group, 22 cases （91.67%） in common positive group and 26 cases （96.30%） in strong positive group. There was statistical difference among three groups （X^2 =18. 732, P〈0.05）, but no statistical difference between strong positive group and common positive group （X^2=0. 011, P= 0. 916〉0. 017）. Statistical difference was found between weakly positive group and common positive group （X^2 = 8. 783, P= 0. 003〈0. 017） and between weakly positive group and strong positive group （X^2 = 12. 738, P= 0. 000〈0. 017）. Conclusion The incidence rates of malignancy are not noticeably different between common positive group and strong positive group. The incidence rate of malignancy was 43.75% in this study indicating that clinicians should watch out for patients of weakly positive group.