Goerres G W, Schmid D T, Grätz K W, von Schulthess G K, Eyrich G K
Division of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich, Switzerland.
Oral Oncol. 2003 Sep;39(6):547-51. doi: 10.1016/s1368-8375(03)00016-2.
The aim of this study is to evaluate the additional clinical information provided by whole body positron emission tomography (PET) with fluorodeoxyglucose (FDG) for initial staging of patients with squamous cell carcinoma (SCC) of the oral cavity. PET scans from the head to the pelvic floor of 34 consecutive patients (22 male, 12 female; mean age 71 years) with histologically confirmed SCC of the oral cavity were retrospectively evaluated. Clinical information including CT of the head and neck and chest X-Ray or chest CT was compared with information on nodal involvement and distant metastases or secondary tumours obtained with PET. The primary tumour was identified with PET in 33 of 34 patients (97%). In 27 Patients (81%) the clinical N-stage was confirmed with PET. In two Patients (6%) additional pathologic loco-regional lymph nodes were found. In five patients more lymph nodes were identified with CT. Distant lesions were seen with PET imaging in bone, lung, mediastinum, liver and colon. In three patients (6%) distant metastases were correctly identified. In another four patients (12%) a secondary cancer was detected. One false positive finding was described with PET. In five of 34 patients (15%) the additional findings as revealed with PET lead to a change of treatment. Whole body PET provides relevant additional information to a standard clinical staging procedure in patients with oral cavity SCC. The detection of distant metastases and secondary primary tumours can have a great impact on patient management.
本研究的目的是评估采用氟脱氧葡萄糖（FDG）的全身正电子发射断层扫描（PET）为口腔鳞状细胞癌（SCC）患者进行初始分期时所提供的额外临床信息。对34例经组织学确诊为口腔SCC的连续患者（22例男性，12例女性；平均年龄71岁）从头部至盆底的PET扫描进行回顾性评估。将包括头颈部CT和胸部X线或胸部CT在内的临床信息与通过PET获得的有关淋巴结受累、远处转移或继发性肿瘤的信息进行比较。34例患者中有33例（97%）通过PET发现了原发性肿瘤。27例患者（81%）的临床N分期通过PET得到确认。2例患者（6%）发现了额外的病理性局部区域淋巴结。5例患者通过CT发现了更多淋巴结。PET成像在骨、肺、纵隔、肝和结肠中发现了远处病变。3例患者（6%）远处转移被正确识别。另外4例患者（12%）检测到继发性癌症。PET出现1例假阳性结果。34例患者中有5例（15%）PET显示的额外发现导致了治疗方案的改变。全身PET为口腔SCC患者的标准临床分期程序提供了相关的额外信息。远处转移和继发性原发性肿瘤的检测可能对患者管理产生重大影响。
