Scott Clare L, Kudaba Iveta, Stewart Josephine M, Hicks Rodney J, Rischin Danny
Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, A'Beckett St, East Melbourne, Victoria, 8006, Australia.
Mol Imaging Biol. 2005 May-Jun;7(3):236-43. doi: 10.1007/s11307-005-4114-x.
A retrospective analysis of the use of 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography (PET) was performed in patients with histologically proven disseminated carcinoma of unknown primary tumor (CUP).
The records of 31 patients with CUP, excluding patients with isolated neck metastases, were reviewed to identify the ability of PET to detect the putative primary site (PPS) and/or to change therapeutic management.
In eight out of 31 cases (26%), a PPS was confirmed, either definitively (one pathologically, one radiologically) (true positive) or clinically (six cases). For three cases (10%), histological evidence of a primary tumor distant from the PPS was found (false positive). In a further seven cases (23%), the PPS remained unconfirmed, whereas for 13 cases (42%) no PPS was identified. In five out of seven patients in whom the PET suggested a high probability of having identified the primary site, the PPS was confirmed definitively or clinically. PET altered clinical management in at least 12 cases (38%).
PET contributed to the management of previously extensively investigated patients with CUP. Identification of a PPS and/or change in management was documented in 38% of cases, the majority of which were lung or pancreatic cancer. These findings are worthy of evaluation in a prospective study.
对经组织学证实的原发灶不明的播散性癌（CUP）患者使用2-脱氧-2-[F-18]氟-D-葡萄糖（FDG）正电子发射断层扫描（PET）进行回顾性分析。
回顾31例CUP患者的记录，不包括孤立性颈部转移患者，以确定PET检测假定原发部位（PPS）和/或改变治疗管理的能力。
31例中有8例（26%）确诊了PPS，其中1例经病理确诊，1例经放射学确诊（真阳性），6例经临床确诊。3例（10%）发现远离PPS的原发肿瘤的组织学证据（假阳性）。另有7例（23%）PPS仍未确诊，13例（42%）未发现PPS。在PET提示很可能已确定原发部位的7例患者中，有5例PPS得到了明确或临床确诊。PET至少在12例（38%）中改变了临床管理。
PET有助于对先前已进行广泛检查的CUP患者进行管理。38%的病例记录了PPS的确定和/或管理的改变，其中大多数为肺癌或胰腺癌。这些发现值得在前瞻性研究中进行评估。
