Kamiyama Yoichi, Aihara Ryuusuke, Nakabayashi Toshihiro, Mochiki Erito, Asao Takayuki, Kuwano Hiroyuki, Oriuchi Nobuo, Endo Keigo
Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
World J Surg. 2005 Nov;29(11):1429-35. doi: 10.1007/s00268-005-0045-6.
The malignant potential of gastrointestinal stromal tumors (GISTs) is difficult to diagnose before surgery because the diagnoses are based on tumor diameter and mitotic index. The progression of small GISTs is always observed because they do not seem to have malignant potential. 18F-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) is a useful technique for assessing tumor activity. The objective of this study was to determine if FDG-PET is useful for predicting the malignant potential of gastric GISTs. Ten patients diagnosed with gastric GISTs participated. FDG-PET was performed on all of them before tumor resection. A whole-body image was initiated 40 minutes after the injection of 275 to 370 MBq FDG. FDG uptake was assessed by a standardized uptake value. All tumors had FDG uptake. There was a significant correlation between the FDG uptake and both the Ki67 index and the mitotic index but not the tumor diameter. The FDG uptake and malignant potential of gastric GISTs had a significant correlation. FDG-PET may be of considerable value for predicting the malignant potential of gastric GISTs before surgery. A gastric GIST with a high FDG uptake should be regarded as having malignant potential.
胃肠道间质瘤(GISTs)的恶性潜能在手术前难以诊断,因为诊断是基于肿瘤直径和有丝分裂指数。小GISTs的进展经常被观察到,因为它们似乎没有恶性潜能。18F-氟脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)是评估肿瘤活性的一种有用技术。本研究的目的是确定FDG-PET是否有助于预测胃GISTs的恶性潜能。十名被诊断为胃GISTs的患者参与了研究。在肿瘤切除前对他们所有人都进行了FDG-PET检查。在注射275至370MBq FDG后40分钟开始进行全身成像。通过标准化摄取值评估FDG摄取情况。所有肿瘤均有FDG摄取。FDG摄取与Ki67指数和有丝分裂指数均有显著相关性,但与肿瘤直径无关。胃GISTs的FDG摄取与恶性潜能有显著相关性。FDG-PET在术前预测胃GISTs的恶性潜能方面可能具有重要价值。FDG摄取高的胃GIST应被视为具有恶性潜能。