^(18)F-FDG PET和CT对食管癌临床分期的价值

Comparison of ^(18)F-FDG-PET and ^(l8)F-FDG-CT Scans for the Clinical Staging of Esophageal Cancer

目的:评价^(18)F-FDG PET和CT判定食管癌术前T、N分期的敏感性、特异性及准确性,并探讨SUV值与食管癌预后的相关性。方法:29例食管癌患者术前均行PET和CT扫描,分别进行T、N分期,并与术后病理分期进行对照分析。结果:与术后病理证实的T、N分期结果比较,CT扫描对判断T分期的准确率明显高于PET,PET扫描对判断N分期的准确率虽高于CT,但差异无统计学意义。仅术前PET扫描检测T分期的一致性较差(Kappa<0.4);术前PET扫描检测N分期、术前CT扫描检测T、N分期一致性均较好(Kappa>0.4)。SUV值与PETsuv2.5显示病变长度及体积呈正相关,SUV值<9.0患者预后好于SUV值≥9.0患者。结论:在判断食管癌临床T分期方面CT较PET具有一定优势,对判断N分期方面,两者准确率均较高。SUV临界值9.0可以作为一项实用的判断预后指标。

Objective： In the present work, the sensitivity, specificity, and accuracy of 18F-FDG-PET and 18F-FDG-CT scans were evaluated during T and N staging of esophageal carcinoma （ EsCa ） and the relationship between SUV values and EsCa survival rates was explored. Methods： Twenty-nine EsCa patients were subjected to PET and CT scans after surgery. Postoperative pathological T and N stages were compared with clinical T and N stages. Results： The accuracy ofT stage EsCa diagnosis by CT was significantly higher than that by PET. Although the accuracy of N stage diagnosis by PET was higher than that by CT, no significant differences between the two scans were observed. It was clear that only the Kappa value of the preoperative PET scan in T stage diagnosis was poor （ Kappa value 〈 0.4 ）. The Kappa values for PET scans in N stage diagnosis and preoperative CT scans in T and N stage diagnosis were all favorable （ Kappa value 〉 0.4 ）. SUV values increased as the volume and length of the tumor determined with PETsuv2, increased. Survival rates of patients with SUV values 〈 9.0 were better than those with SUV values ≥ 9.0. Conclusion： Compared with PET scans, CT scans have a definite advantage during T stage diagnosis of EsCa. The accuracies of N stage diagnosis by both CT and PET examinations are high. An SUV value of 9.0 may be regarded as a practical index to determine the prognosis of EsCa.