PET-CT在监测卵巢恶性生殖细胞肿瘤复发中的应用

The role of PET-CT in the detection of recurrent malignant ovarian germ cell tumor

目的 评价18F-脱氧葡萄糖(18F-FDG)全身正电子发射断层显像-电子计算机断层扫描(positron emission tomography-computedtomography,PET-CT)在卵巢恶性生殖细胞肿瘤(malignant ovarian germ cell tumor,MOGCT)复发中的作用。方法 回顾性分析北京协和医院2009年5月至2019年2月为评估MOGCT复发情况行全身PET-CT检查的25例患者的临床资料,比较分析PET-CT检查结果与临床资料。结果 25例患者共进行27次全身PET-CT检查,在25次PET-CT检查后患者接受了手术治疗。PET-CT检查结果为真阳性22次,真阴性1次,假阳性4次,无假阴性病例。PET-CT检测MOGCT复发的敏感性、特异性、阳性预测值和阴性预测值分别为100%、20%、84.6%和100%,正确率为85.2%(23/27)。假阳性的良性病变主要是炎症和0级未成熟畸胎瘤。结论 全身PET-CT在监测MOGCT复发中有较高价值,敏感性和阴性预测值高,是否能够成为监测MOGCT复发的常规检测方法尚需要大样本前瞻性研究。

Objective To evaluate the role of whole-body 18F-FDG PET-CT in the detection of recurrent malignant ovarian germ cell tumor(MOGCT).Method 25 patients undergone PET-CT to evaluate for MOGCT recurrence at Peking Union Medical College Hospital between May 2009 and February 2019 were retrospectively analyzed.PET-CT findings were compared to histopathological results and other available clinical data to classify each PET-CT result as a true positive,true negative,false positive,or false negative.Result 25 patients underwent 27 PET-CT,and 25 operations were undergone after PET-CT.There were 22 true positive,4 false positive,1 true negative and no false negative.The sensitivity of PET-CT for detecting recurrent MOGCT was 100%,specificity of 20%,positive predictive value of 84.6%,negative predictive value of 100%,and accuracy of 85.2%.Of these 4 false positive patients,there were 2 with inflammation and 2 with grade 0 immature teratoma.Conclusion PET-CT is promising for detection of MOGCT recurrence,with high sensitivity and negative predict value.A large prospective study is needed to determine whether this modality should be used routinely in the detection of recurrent MOGCT.