地方性鼻咽癌远处转移分期的4种方式比较。
Comparison of 4 modalities for distant metastasis staging in endemic nasopharyngeal carcinoma.
作者信息
Chua Melvin Lee Kiang, Ong Seng Chuan, Wee Joseph Tien Seng, Ng David Chee Eng, Gao Fei, Tan Terence Wee Kiat, Fong Kam Weng, Chua Eu Tiong, Khoo James Boon Kheng, Low John Seng Hooi
机构信息
Department of Radiation Oncology, National Cancer Centre, Singapore.
出版信息
Head Neck. 2009 Mar;31(3):346-54. doi: 10.1002/hed.20974.
BACKGROUND
Endemic nasopharyngeal carcinoma (NPC) commonly metastasizes to the lungs, liver, and bones. This study aims to assess the efficacy of 4 distant metastasis staging modalities, namely (1) conventional work-up comprising chest X-ray, liver ultrasound, and skeletal scintigraphy, (2) CT of the thorax, abdomen, and skeletal scintigraphy, (3) (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET), and (4) integrated FDG-PET/CT.
METHODS
Seventy-eight consecutive patients diagnosed with NPC were enrolled and followed up for a minimum of 6 months to confirm the staging at diagnosis.
RESULTS
Six patients (7.7%) had distant metastases at diagnosis. The sensitivities and specificities of conventional work-up, combined CT and skeletal scintigraphy, FDG-PET, and FDG-PET/CT were 33.3%, 66.7%, 83.3%, and 83.3%; and 90.3%, 91.7%, 94.4%, and 97.2%, respectively. The corresponding accuracies were 85.9%, 89.7%, 93.6%, and 96.2%.
CONCLUSIONS
FDG-PET/CT is the most sensitive, specific, and accurate modality for distant metastasis staging of endemic NPC.
背景
地方性鼻咽癌（NPC）常转移至肺、肝和骨。本研究旨在评估4种远处转移分期方式的疗效，即（1）包括胸部X线、肝脏超声和骨闪烁显像的传统检查，（2）胸部、腹部CT和骨闪烁显像，（3）（18）F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET），以及（4）FDG-PET/CT一体化检查。
方法
纳入78例连续诊断为NPC的患者，并进行至少6个月的随访以确认诊断时的分期。
结果
6例患者（7.7%）在诊断时已有远处转移。传统检查、CT与骨闪烁显像联合、FDG-PET以及FDG-PET/CT的敏感性和特异性分别为33.3%、66.7%、83.3%、83.3%和90.3%、91.7%、94.4%、97.2%。相应的准确率分别为85.9%、89.7%、93.6%和96.2%。
结论
FDG-PET/CT是地方性NPC远处转移分期最敏感、特异和准确的方式。
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