PET/CT在探查胃肠道黏液腺癌和印戒细胞癌术后转移中的作用

The role of PET/CT in detecting the metastasis of postoperative gastrointestinal mucinous adenocarcinoma and signet-ring cell carcinoma

目的探讨PET/CT在探查胃肠道黏液腺癌和印戒细胞癌术后转移中的作用和限度。方法对41例胃肠道黏液腺癌和印戒细胞癌术后患者(A组)和51例其他细胞类型的胃肠道癌术后患者(B组)行PET/CT检查。其中36例经再次手术或穿刺等获得病理证实,55例随访6月以上确诊,测量并比较两组转移瘤最大标准摄取值(standard uptake value,SUVmax),比较PET/CT检查在两组患者中的效用。结果 A组最终确诊31例转移,10例无转移,PET/CT真阳性23例,假阳性1例,真阴性9例,假阴性8例,敏感性和特异性分别为74.2%和90.0%。B组25例阳性,26例阴性,PET/CT检查真阳性为23例,假阳性3例,真阴性为23例,假阴性2例,敏感性和特异性分别为92.0%和88.5%。两组转移瘤SUVmax差异没有统计学意义(P>0.05)。结论以PET/CT检查胃肠道黏液腺癌和印戒细胞癌术后转移的假阴性高于其他细胞类型的癌,因此结合临床症状和其他检查是十分必要的。

Objective To explore the role and limitation of PET/CT in detecting the postoperative metastasis of gastrointestinal mucinous adenocarcinoma and signet-ring cell carcinoma.Methods PET/CT was performed in 41 patients with gastrointestinal mucinous adenocarcinoma and signet-ring cell carcinoma after operation（A group） and in 51 cases with postoperative gastrointestinal other type cell carcinoma（B group）.The final diagnoses were obtained by histopathological verification in 36 cases and by more than 6-months follow-up in 55 patients.The SUVmax of lesions in two groups were measured and the efficiency of PET/CT examination between two groups were compared.Results The final diagnoses in group A included 31 patients with metastases10 patients without metastasis.23 patients with metastasis were confirmed by using PET/CT,one patient was false positive,9 patients were true negative,8 patients were false negative.The sensitivity and specificity of PET/CT were 74.2% and 90.0% respectively.In group B,the metastases were confirmed in 25 cases and no metastasis was in 26 patients.23 cases were confirmed by PET/CT,3 were false positive,23 cases were true negative,2 cases were false negative.The sensitivity and specificity of PET/CT were 92.0% and 88.5% respectively.No statistical differences were found in SUVmax of metastatic lesions between two groups.Conclusion It was necessary to combine the clinical symptoms and other examination in detecting the metastasis of postoperative gastrointestinal mucinous adenocarcinoma and signet-ring cell carcinoma.There is a higher false negative in these patients with examination of PET/CT than in other type cell carcinoma.