Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Head Neck. 2010 Mar;32(3):319-25. doi: 10.1002/hed.21184.
This study assesses the additional value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/CT ((18)F-FDG-PET/CT) with respect to synchronous primaries in patients undergoing panendoscopy for staging of head and neck squamous cell carcinoma.
In all, 311 patients underwent both modalities. Cytology, histology, and/or clinical/imaging follow-up served as reference standard.
The prevalence of second primary tumors detected by panendoscopy was 4.5%, compared with 6.1% detected by (18)F-FDG-PET/CT. The sensitivity for panendoscopy was 74%, the specificity was 99.7%, the positive predictive value (PPV) was 93%, and the negative predictive value (NPV) was 98%. The sensitivity for (18)F-FDG-PET/CT was 100%, the specificity was 95.7%, the PPV was 59%, and the NPV was 100%.
(18)F-FDG-PET/CT is superior to panendoscopy. With a negative (18)F-FDG-PET/CT, the extent of endoscopy can be reduced to the area of the primary tumor. Due to the costs, (18)F-FDG-PET/CT is recommended only in advanced disease to assess potential distant disease. In early-stage cancer, panendoscopy is accurate enough to rule out secondary tumors.
本研究评估了（18）F-氟代-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描（（18）F-FDG-PET/CT）在头颈部鳞癌患者行全景内镜分期时同步原发性肿瘤的附加价值。
共有 311 例患者同时接受了这两种检查。细胞学、组织学和/或临床/影像学随访作为参考标准。
全景内镜检查发现第二原发肿瘤的患病率为 4.5%，而（18）F-FDG-PET/CT 检查发现的患病率为 6.1%。全景内镜的灵敏度为 74%，特异性为 99.7%，阳性预测值（PPV）为 93%，阴性预测值（NPV）为 98%。（18）F-FDG-PET/CT 的灵敏度为 100%，特异性为 95.7%，PPV 为 59%，NPV 为 100%。
（18）F-FDG-PET/CT 优于全景内镜。（18）F-FDG-PET/CT 阴性时，可以将内镜的范围缩小到原发性肿瘤的区域。由于成本原因，（18）F-FDG-PET/CT 仅推荐用于晚期疾病，以评估潜在的远处疾病。在早期癌症中，全景内镜足以排除继发性肿瘤。
