18F-FDG PET-CT监测小肠腺癌术后复发及转移的价值

Value of 18F-FDG PET-CT in monitoring recurrence and metastasis of small intestinal adenocarcinoma

目的：评价18F-FDG PET-CT在小肠腺癌术后复发、转移监测中的临床价值及其对临床治疗决策的影响。方法回顾性分析22例小肠腺癌术后行18F-FDG PET-CT检查患者的临床及随访资料，将PET-CT检查结果与临床随访（再次手术后病理检查和长期随访观察）的结果进行对比分析，并分析PET-CT对临床决策的影响。结果22例患者中，14例经临床随访确诊为复发和（或）转移，8例无明显复发和（或）转移。18F-FDG PET-CT诊断13例为复发和（或）转移（真阳性12例，假阳性1例）；无明显复发和（或）转移9例（假阴性2例）。18F-FDG PET-CT对小肠腺癌术后复发和（或）转移诊断的灵敏度、特异度、准确率、阳性预测值及阴性预测值分别为85.7%（12／14）、87.5%（7／8）、86.4%（19／22）、92.3%（12／13）和77.8%（7／9）。基于PET-CT结果，45.5%（10／22）患者的治疗方案发生改变。结论18F-FDG PET-CT在小肠腺癌术后复发和（或）转移的诊断中具有重要的临床价值，是一种较理想的监测方法。

Objective To evaluate the clinical value of 18F-FDG PET-CT imaging on monitoring recurrence, metastasis and therapeutic decision-making in small intestinal adenocarcinoma patients after radical surgery. Methods Twenty-two patients were enrolled, who underwent surgical operation before received PET-CT scan. PET-CT findings were retrospectively observed to compare with the results of follow-up [postoperative pathology and （or） long-term clinical follow-up]. The roles of PET-CT on therapeutic decision-making were then investigated. Results Among 22 patients, 14 cases were finally diagnosed as recurrence and （or） metastasis, the other 8 cases as disease-free survival after long-term follow-up. According to PET-CT, 13 cases were diagnosed as recurrence and （or） metastasis （including 12 true-positive and 1 false-positive）, and 9 cases were negative （including 2 false-negative）. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET-CT were 85.7 % （12/14）, 87.5 % （7/8）, 86.4 %（19/22）, 92.3%（12/13） and 77.8%（7/9）, respectively. The therapeutic decisions were changed in 10 patients （10/22, 45.5 % ） based on PET-CT results. Conclusion 18F-FDG PET-CT has an important clinical value on the detection of recurrence and （or） metastasis of small intestinal adenocarcinoma, which is an ideal method of monitoring.