增强CT联合^(18)F-FDG PET/CT评估肾透明细胞癌分期和静脉癌栓分级的临床价值

^(18)F-FDG PET/CT combined with enhanced CT in the diagnosis of renal clear cell carcinoma staging and venous tumor thrombus grading

目的探讨增强CT联合^(18)F-氟代脱氧葡萄糖正电子发射断层扫描术/计算机层析成像^(18)F-2-deoxy-D-glucose positron emission tomography/computed tomography,^(18)F-FDG PET/CT)评估肾透明细胞癌(renal clear cell carcinoma,RCCC)分期和静脉癌栓分级的临床价值。方法选取本院2015年1月至2017年1月收治68例RCCC患者为研究对象,分别采用^(18)F-FDG PET/CT、增强CT及增强CT联合^(18)F-FDG PET/CT(简称联合检查)进行检查,记录并比较三种检查方式对静脉癌栓的检出率及原发肿瘤TNM分期的评估结果。结果联合检查对RCCC合并静脉癌栓的检出率显著高于增强CT和^(18)F-FDG PET/CT检查(P<0.05)。三种检查方式对肿瘤T分期的诊断准确率分别为:联合检查>^(18)F-FDG PET/CT>增强CT,组间比较差异均具有显著性(P<0.05);联合检查与^(18)F-FDG PET/CT对T0—T1分期的诊断准确率>90.00%,对T2—T4分期的诊断准确率<90%。三种检查方式对肿瘤NM分期的特异度和敏感度分别为:联合检查>^(18)F-FDG PET/CT>增强CT,组间比较差异均具有显著性(P<0.05)。结论增强CT联合^(18)F-FDG PET/CT能够显著提高对RCCC转移情况、肿瘤分期及静脉癌栓分级的诊断准确率。

ObjectiveTo investigate the clinical value of F-2-deoxy-D-glucose positron emission tomography/computed tomography （18F-FDG PET/CT） combined with enhanced CT in the diagnosis of renal clear cell carcinoma （RCCC） staging and venous tumor thrombus grading. Method68 patients with RCCC were selected as observation objects in our hospital from January 2015 to January 2017, and were detected by 18F-FDG PET/CT, enhanced CT and joint examination. The results of diagnosis, primary tumor T staging and abdominal TNM staging of three methods were recorded and compared. ResultThe detection rate of joint examination for RCCC combined with venous thrombus was significantly higher than that of enhanced CT and 18F-FDG PET/CT （P〈0.05）. The diagnostic accuracy rate of the three methods for tumor T staging was respectively： joint examination 〉 18F-FDG PET/CT 〉 enhanced CT, the difierences were significant （P〈0.05）. The diagnostic accuracy rate of joint examination and 18F-FDG PET/CT for tumor T0-T1 staging were 〉 90.00%, and the diagnostic accuracy rate for tumor T2-T4 staging were 〈90.00%. The specificity and sensitivity of the three methods for the tumor NM staging were respectively： joint examination 〉 18F-FDG PET/CT 〉 enhanced CT, the difierences were significant （P 〈 0.05）. ConclusionEnhanced CT combined with 18F-FDG PET/CT can significantly improve the diagnostic accuracy rate of RCCC metastasis, tumor staging and venous tumor thrombus grading.