^(18)F-FDG PET-CT在肝外胆管细胞癌术前诊断及分期中的价值

^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography in the preoperative diagnosis and staging of extrahepatic cholangiocarcinoma

目的分析^(18)氟-脱氧葡萄糖(^(18)F-FDG)正电子发射型电子计算机断层(PET-CT)在肝外胆管细胞癌术前诊断及分期中的应用价值。方法对2010年5月至2017年9月就诊的103例疑似肝外胆管细胞癌患者的临床资料进行回顾性分析,患者均于术前进行了^(18)F-FDG PET-CT显像和增强CT扫描,以病理诊断为标准对比不同诊断方式的诊断效能。结果 103例患者中共有92例患者为恶性肿瘤,11例患者为良性肿瘤,^(18)F-FDG PET-CT诊断和增强CT诊断在肿瘤性质、肿瘤类型、胆管癌分化程度以及胆管癌转移情况与病理诊断结果相比差异无统计学意义(P>0.05);^(18)F-FDG PET-CT的诊断灵敏度、特异度、阴性预测值和诊断符合率分别为97.83%、100.00%、84.62%和98.06%,均高于增强CT(90.22%、81.82%、50.00%、89.32%),差异有统计学意义(P<0.05,P<0.01),但两种诊断方式的阳性预测值相当(100.00%vs 97.65%,P>0.05)。结论^(18)F-FDG PET-CT可以有效应用于肝外胆管细胞癌术前的临床诊断中,有利于对患者进行术前评估和分期判断。

Objective To investigate the 18F-fluorodeoxyglucose positron emission tomography/computed tomography （ 18F-FDG PET/CT） in the preoperative diagnosis and staging of extrahepatic cholangiocarcinoma. Methods The clinical data of 103 suspected extrahepatic cholangioearcinoma patients from May 2010 to September 2017 were retrospectively analyzed. All the patients received 18 F-FDG PET/CT and enhanced CT scanning before the operation, and the diagnostic effects of different diagnostic were compared. Results There were 92 cases of malignancy and 11 cases of benign tumor in 103 patients. There were no significant differences in tumor size, tumor type, cholangiocarcinoma differentiation and metastasis between 18 F-FDG PET/CT,enhanced CT scanning and pathological diagnosis. Diagnostic sensitivity, specificity, negative predictive value and diagnostic accuracy of 18 F-FDG PET/CT were higher than those of enhanced CT （97.83 % vs 90. 22% , 100% vs 81.82% , 84. 62% vs 50. 00% , 98.06% vs 89. 32% , P 〈 0. 05, P 〈 0. 01 ）. However, there was no significant difference in the positive predictive value between the two diagnostic （ 100. 00% vs 97. 65% , P 〉 0. 05 ）. Conclusion 18 FDG PET/CT could be applied to the preoperative diagnosis of extrahepatic cholangiocarcinoma and it is helpful for preoperative assessment and staging of patients.