F18-FDG PET/CT显像在结肠癌诊断中的临床价值

The Clinical Value of F18-FDG PET/CT Imaging for Colon Cancer Diagnosis

目的探讨F18-FDG PET/CT显像在临床上诊断结肠癌的价值。方法回顾性分析该院2008年3月—2014年9月以来160例肠镜检查发现结肠肿瘤的患者,行F18-FDG PET/CT显像,将所得诊断结果与结肠镜下活检的病理结果对照,以探讨F18-FDG PET/CT显像诊断结肠癌的准确率、敏感性和特异性。结果 1F18-FDG PET/CT显像发现结肠内肿块、肠壁无增厚改变,PET表现为高代谢灶,诊断为结肠癌的病例共85例中,结肠镜活检后病理结果其中结肠腺癌57例、高功能腺瘤8例、炎性息肉20例;2F18-FDG PET/CT显像发现结肠局部肠壁增厚、肠腔狭窄、PET表现为高代谢灶,诊断为结肠癌的病例12例中,结肠镜活检后病理结果其中结肠腺癌10例、慢性炎性病变2例;3F18-FDG PET/CT显像发现结肠肿块且局部肠壁增厚、肠腔狭窄,PET表现为高代谢灶,诊断为结肠癌的病例44例,结肠镜活检后病理结果均为结肠腺癌;4F18-FDG PET/CT显像为阴性显像的19例病例中,结肠镜检查后活检病理结果其中12例为炎性息肉,4例为高功能腺瘤,2例为粘液腺癌,1例为印戒细胞癌。F18-FDG PET/CT融合显像诊断结肠癌的准确率为79.4%、敏感性为97.4%、特异性为34.8%。结论 F18-FDG PET/CT显像在结肠癌的诊断中具有较高敏感性,但准确率及特异性较低,特别是只发现结肠内肿块而肠壁无增厚、肠腔无狭窄的病例。因此在临床诊断上一定要结合结肠镜活检的检查结果。

Objective To discuss the diagnostic value of F18-FDG PET/CT imaging for colon cancer. Methods The retrospective analysis was done on 160 cases colon tumor found in recent 6 years by colonoscopy or clinical manifestations that were given the F18-FDG PET/CT imaging afterwards. The imaging diagnostic results were compared with the postoperative pathological or colonoscopy biopsy results so as to discuss the diagnostic accuracy, sensitivity and specificity of the F18-FDG PET/CT imaging for colon cancer. Results ①Among the 85 cases diagnosed as colon cancer by F18-FDG PET/CT Imaging showing intra-colon tumor and hyper-metabolic lesions without thickening of colon wall, postoperative or colonscopy biopsy pathology findings showed that57 cases were adenocarcinoma, 8 cases were high-function adenoma and 20 cases were inflammatory polyps. ② Among the 12 cases diagnosed as colon cancer by F18-FDG PET/CT Imaging showing local thickening and narrowing of colon wall and hypermetabolic lesions, postoperative or colonscopy biopsy pathology findings showed that 10 cases were colon adenocarcinoma, 2 cases were chronic inflammatory change. ③ For the 44 cases diagnosed as colon cancer by F18-FDG PET/CT Imaging showing colon mass and local thickening and narrowing and hyper-metabolic lesions, the postoperative or colonscopy biopsy pathology findings showed colon adenocarcinoma. 4Among the 19 cases showed negative by F18-FDG PET/CT Imaging, 12 cases were inflammatory polyps, ④ cases were high function adenoma and 2 cases were mucous adenocarcinoma, 1 case was signet ring cell carcinoma. The accuracy was 79.4%, the sensitivity was 97.4% and specificity was 34.8%. Conclusions The F18-FDG PET/CT imaging shows relatively higher sensitivity. But the accuracy and specificity are relatively low. It is only indicated for masses inside the colon without the thickening of colon wall or narrowing of colon cavity. So the diagnosis must be combined with the results of colonoscopy biopsy.