^(18)F-脱氧葡萄糖PET显像在原发灶不明转移癌中的应用

Whole body ^(18)F-deoxyglucose positron emission tomography in detecting the primary focus of metastatic cancer with an unknown primary

目的 探讨18F -脱氧葡萄糖 (FDG)正电子发射型体层摄影术 (PET)全身显像在原发灶不明转移癌中的作用。方法 对 2 9例原发灶不明转移癌患者行FDGPET全身显像 ,并与临床随诊、组织活检和手术病理结果对照。结果 2 9例原发灶不明转移癌患者 ,FDGPET发现可疑原发灶 15例 ,其中 13例为病理结果所证实 ,2例病理结果为阴性 ,FDGPET对原发灶的检出率为 44 .8% (13/2 9)。FDGPET全身显像另外检出淋巴结转移和远地转移灶 2 6个 ,CT和 (或 )MRI只检出 13个。 14例FDGPET未确定原发灶者 ,经随访 3～ 13个月 ,死亡率为 42 .9% (6 / 14)。 13例FDGPET确定原发灶者 ,经过有针对性的治疗 ,经随访 2～ 13个月 ,死亡率为 15 .4% (2 / 13)。结论 FDGPET全身显像对原发灶不明转移癌原发灶的确定、临床分期、治疗方案的制定以及预后的改善均有一定的价值。

Objective To evaluate the value of 18 F-deoxyglucose (FDG) positron emission tomography (PET) in detecting the primary focus of metastatic cancer with an unknown primary. Methods Twenty-nine patients with various histological types of metastases from an unknown primary after extensive conventional diagnostic work-up were studied. After intravenous 370 MBq FDG, whole body scan was made 50 minutes after injection. The results of FDG PET were compared with those of CT or MRI. Results With FDG PET, the primary tumors were identified in 13 patients and confirmed by pathology. The corresponding detection rate was 44.8% (13/29) as compared with 27.6% (8/29) by CT or MRI. In addition, 26 metastases were discovered by FDG PET whole body imaging but only 13 were found by CT or MRI. During 2～13 months' follow-up, the mortality rates were 15.4%(2/13) and 42.9%(6/14) for patients with the primary tumor identified or unidentified. Conclusions FDG PET is valuable in staging, selecting appropriate treatment protocol and predicting prognosis for patients suffering from metastatic cancers with an unknown primary.