Rodríguez-Fernández Antonio, Gómez-Río Manuel, Llamas-Elvira José Manuel, Ortega-Lozano Simeón, Ferrón-Orihuela Jose Antonio, Ramia-Angel Jose Manuel, Mansilla-Roselló Alfonso, Martínez-del-Valle María Dolores, Ramos-Font Carlos
Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Avda/ Fuerzas Armadas 2, Granada 18014, Spain.
Am J Surg. 2004 Aug;188(2):171-5. doi: 10.1016/j.amjsurg.2003.12.070.
Recent advances in hepatobiliary surgery have underscored the need for presurgical diagnosis of gallbladder cancer. Frequently, clinical presentation, biochemical analysis, and structural ultrasound or computed axial tomography images do not enable definitive differentiation of cholecystitis or cholethiasis from gallbladder cancer. The aim of this study was to evaluate the role of fludeoxy glucose-positron-emission tomography (FDG-PET) in establishing the benign or malignant nature of gallbladder lesions.
A case series of 16 patients with clinical symptoms suggestive of biliary colic or chronic cholecystitis and with inconclusive ultrasound and/or computed axial tomography findings for presence of gallbladder cancer were studied by FDG-PET.
FDG-PET showed a sensitivity of 0.80, a specificity of 0.82, and positive and negative predictive values of 0.67 and 0.90, respectively. There was 1 false- negative result in 1 patient with mucinous adenocarcinoma and 2 false-positive results in 1 patient with tuberculoid granulomatous reaction and 1 patient with polypoid lesion with adenomyomatosis.
FDG-PET may be of utility to establish the diagnosis of gallbladder cancer in patients with nonspecific clinical and imaging findings.
肝胆外科的最新进展凸显了胆囊癌术前诊断的必要性。通常，临床表现、生化分析以及结构超声或计算机断层扫描图像无法明确区分胆囊炎或胆石症与胆囊癌。本研究的目的是评估氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在确定胆囊病变的良恶性方面的作用。
对16例有胆绞痛或慢性胆囊炎临床症状且超声和/或计算机断层扫描结果不能确定是否存在胆囊癌的患者进行了FDG-PET研究。
FDG-PET的敏感性为0.80，特异性为0.82，阳性预测值和阴性预测值分别为0.67和0.90。1例黏液腺癌患者出现1例假阴性结果，1例结核样肉芽肿反应患者和1例伴有腺肌病的息肉样病变患者出现2例假阳性结果。
对于临床和影像学表现不特异的患者，FDG-PET可能有助于诊断胆囊癌。
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