^(18)F-FDG PET/CT对初诊食管鳞癌的诊断价值

Diagnostic value of ^(18)F-FDG PET/CT in newly diagnosed esophageal squamous cell carcinoma

目的研究^(18)F-氟代脱氧葡萄糖(FDG)PET/CT对初诊食管鳞癌的诊断价值。方法经胃镜活检证实的食管鳞癌患者47例,治疗前均行^(18)F-FDG PET/CT全身扫描和颈胸腹部CT扫描。比较^(18)F-FDG PET/CT和CT诊断食管鳞癌原发灶、区域淋巴结转移和远处转移的效率。结果 ^(18)F-FDG PET/CT诊断原发灶与内镜病理结果符合率为98.0%,稍高于CT的87.8%(P>0.05)。以术后病理诊断为参照,^(18)F-FDG PET/CT诊断区域淋巴结转移的灵敏度、特异度和准确度分别为75.0%、99.7%和99.0%,也与CT的66.7%、99.2%和98.2%相仿(P>0.05)。但^(18)F-FDG PET/CT诊断远处转移的灵敏度和准确度分别为91.8%和87.5%,高于CT的67.2%和59.7%(P<0.05)。结论 ^(18)F-FDG PET/CT在诊断食管鳞癌远处转移灶方面优于CT,而在诊断原发灶及区域淋巴结转移方面未显示出明显优势。

Objective To study the diagnostic performance of 18F-fluorodeoxyglucose(18F-FDG)PET/CT in newly diagnosed esophageal squamous cell carcinoma(ESCC).Methods The 18F-FDG PET/CT whole body scan and cervical,thoracic and abdominal CT examination in two weeks were performed in 47 ESCC patients newly diagnosed by gastroscopy and biopsy.The dignostic efficiency of18F-FDG PET/CT and CT for primary lesion and regional and distant lymph node metastasis were compared.Results The pathologic coincidence rate of 18F-FDG PET/CT for the diagnosis of primary tumor was 98.0%,which was slightly higher than 87.8% of CT(P>0.05).Taking pathologic diagnosis of biopsy as the standard for the diagnosis of regional lymph node metastasis,the sensitivity,specificity and accuracy of 18F-FDG PET/CT were 75.0%,99.7%and 99.0%,which were similar to66.7%,99.2% and 98.2% of CT(P>0.05).The sensitivity and accuracy of 18F-FDG PET/CT in diagnosing distant metastasis were 91.8% and 87.5%,which were higher than 67.2%and 59.7% of CT(P<0.05).Conclusion 18F-FDG PET/CT is superior to CT in the diagnosis of distant metastasis of ESCC,but has no obvious advantages in the diagnosis of primary tumor and regional lymph node metastasis.