利用（18）F-FDG PET检测食管癌远处转移。

Detection of distant metastases in esophageal cancer with (18)F-FDG PET.

作者信息

Heeren Pierre A M, Jager Pieter L, Bongaerts Fons, van Dullemen Hendrik, Sluiter Wim, Plukker John Th M

机构信息

Department of Surgical Oncology, University Hospital of Groningen, Groningen, The Netherlands.

出版信息

J Nucl Med. 2004 Jun;45(6):980-7.

PMID:15181133

Abstract

UNLABELLED

Standard staging of esophageal and gastroesophageal junction (GEJ) tumors substantially lacks accuracy. The aim of this study was to investigate whether the addition of PET with (18)F-FDG is a valuable gain in the initial staging.

METHODS

Between January 1996 and January 2002, (18)F-FDG PET was performed in 74 patients. Conventional staging included CT in all patients and well-performed endoscopic ultrasonography (EUS) in 52 patients. They were compared with (18)F-FDG PET with pathology and follow-up of suspicious lesions as the gold standard.

RESULTS

PET identified 70 primary tumors (sensitivity, 95%). Sensitivity to identify locoregional metastases was highest for EUS (69%) but was not different for CT and PET (44% and 55%, respectively). PET was able to identify distant nodal disease in 71% (17/24 patients) compared with 29% (7/24 patients) after combined CT/EUS alone (P = 0.021). Sensitivity to detect distant nodal and systemic (M1) disease increased with PET (78% vs. 37%; P = 0.012). PET upstaged 15 patients (15/74; 20%) correctly as M1 disease, missed by CT/EUS, and correctly downstaged 4 patients (5%) from M1 to M0 disease. However, false upstaging and downstaging was encountered in 5 (7%) and 3 (4%) patients, respectively.

CONCLUSION

PET improves the currently applied staging of esophageal and GEJ tumors, particularly by ameliorating the detection of M1 disease.

摘要

未标注

食管和胃食管交界（GEJ）肿瘤的标准分期准确性严重不足。本研究的目的是调查添加（18）F-FDG的PET在初始分期中是否是一项有价值的补充。

方法

1996年1月至2002年1月期间，对74例患者进行了（18）F-FDG PET检查。所有患者均进行了常规分期，其中52例患者还进行了高质量的内镜超声检查（EUS）。将其与以病理检查及对可疑病变的随访为金标准的（18）F-FDG PET结果进行比较。

结果

PET识别出70例原发性肿瘤（敏感性为95%）。EUS识别局部区域转移的敏感性最高（69%），但CT和PET的敏感性无差异（分别为44%和55%）。PET能够识别71%（17/24例患者）的远处淋巴结疾病，而单独联合CT/EUS后识别率为29%（7/24例患者）（P = 0.021）。PET检测远处淋巴结和全身（M1）疾病的敏感性有所提高（78%对37%；P = 0.012）。PET正确地将15例患者（15/74；20%）上调为M1疾病，这是CT/EUS漏诊的，并且正确地将4例患者（5%）从M1疾病下调为M0疾病。然而，分别有5例（7%）和3例（4%）患者出现了假上调和假下调情况。