18F-FDG PET/CT在阴茎鳞状细胞癌术后评估复发和转移中的应用价值

Application value of ^(18)F-FDG PET/CT in evaluating post-operative recurrence and metastasis of penile squamous cell carcinoma

目的 :探讨18氟-氟代脱氧葡萄糖(uorine-18-uorodeoxyglucose,18F-FDG)PET/CT检查在监测阴茎鳞状细胞癌术后复发和转移中的应用价值。方法 :选取本院2011年5月—2017年6月收治的术后病理确诊为阴茎鳞状细胞癌的50例患者作为研究对象。以病理结果或18F-FDG)PET/CT检查后1年随访结果为金标准,回顾性分析了采用18F-FDGPET/CT显像检查该50例患者术后复发及转移的检出情况。结果 :18F-FDGPET/CT显像检查结果对照病理学及随访结果后确诊,50例患者中有31例发生了复发和转移。术后18F-FDGPET/CT显像阳性者36例,其中6例为假阳性;阴性者14例,其中1例为假阴性;18F-FDGPET/CT诊断的敏感度为96.8%,特异度为68.4%,准确率为86.0%,假阳性率为31.6%,假阴性率为3.2%,阳性预测值为83.3%,阴性预测值为92.9%。31例发生复发和转移的患者中共确诊60个病灶,不同部位复发和转移病灶间最大标准摄取值(maximum standard uptake value,SUVmax)的差异无统计学意义(P=0.088)。确诊转移淋巴结SUVmax与假阳性淋巴结SUVmax的差异无统计学意义(P=0.195)。60岁以上(> 60岁)或临床分期为Ⅲ和Ⅳ期患者术后复发和转移的发生率均明显高于60岁以下(≤60岁)或临床分期为Ⅰ和Ⅱ期的患者,差异具有统计学意义(P值均<0.05)。结论 :18F-FDGPET-CT检查对诊断阴茎鳞状细胞癌术后复发和转移具有较高的灵敏度和准确性,但也存在一定的假阳性率。

Objective: To explore the value of fluorine-18-fluorodeoxyglucose ( 18 F-FDG) PET/CT imaging in monitoring postoperative recurrence and metastasis of penile squamous cell carcinoma.Methods: A total of 50 patients with penile squamous cell carcinoma received therapy in Peking University Cancer Hospital from May 2011 to June 2017 were collected as the study subjects. The PET/CT imaging was used to monitor the recurrence and metastasis of tumor, while the pathology result and follow-up data were considered as the gold standard. Results: Based on the pathology result and follow-up data, 18 F-FDG PET/CT imaging results showed 31 of the 50 patients had recurrence and metastases. 18 F-FDG PET/CT positive imaging was found in 36 patients with 6 false positive cases, and 18 F-FDG PET/CT negative imaging was found in 14 patients with 1 false negative case. The sensitivity, specificity and accuracy of 18 F-FDG PET/CT were 96.8%, 68.4% and 86.0%, respectively; the false positive rate and the false negative rate were 31.6% and 3.2%, respecively; the positive predictive value and the negative predictive value were 83.3% and 92.9%, respecively. A total of 60 lesions were detected in 31 patients with recurrence and metastases. There was no significant difference in maximum standard uptake value (SUV max ) among the metastatic tumors of different sites ( P = 0.088). The SUV max had no significant difference between the true positive lymph nodes and the false positive lymph nodes ( P = 0.195). The recurrence and metastasis rates of the TNM stage Ⅲ-Ⅳ patients older than 60 years of age were higher than those of the TNM stage Ⅰ-Ⅱ patients younger than 60 years of age (both P < 0.05). Conclusion: The 18 F-FDG PET/CT examination has high sensitivity and accuracy for the diagnosis of postoperative recurrence and metastasis of penile squamous cell carcinoma, but there are still some false positive results.