Minnan PET Center, the First Affiliated Hospital of Xiamen University, Xiamen, Fujian Province, China.
World J Gastroenterol. 2010 Aug 21;16(31):3964-9. doi: 10.3748/wjg.v16.i31.3964.
To evaluate the capacity of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) for detecting multiple primary cancer of upper gastrointestinal (UGI) tract.
Fifteen patients (12 without cancer histories and 3 with histories of upper GI tract cancer) were investigated due to the suspicion of primary cancer of UGI tract on X-ray barium meal and CT scan. Subsequent whole body (18)F-FDG PET/CT scan was carried out for initial staging or restaging. All the patients were finally confirmed by endoscopic biopsy or surgery. The detection rate of multiple primary malignant cancers was calculated based on (18)F-FDG PET/CT and endoscopic examinations.
(18)F-FDG PET/CT scan was positive in 32 suspicious lesions, 30/32 were true positive primary lesions, and 2/32 were false positive. In 15 suspicious lesions with negative (18)F-FDG PET/CT scan, 12/15 were true negative and 3/15 were false negative. Among the 15 patients, 12 patients had 29 primary synchronous tumors confirmed by pathology, including 8 cases of esophageal cancers accompanied with gastric cancer and 4 of hypopharynx cancers with esophageal cancer. The other 3 patients had 4 new primary metachronous tumors, which were multiple primary esophageal cancers. PET/CT imaging detected local lymph node metastases in 11 patients. Both local lymph node metastases and distant metastases were detected in 4 patients. On a per-primary lesion basis, the sensitivity, specificity, accuracy, negative predictive value and positive predictive value of (18)F-FDG PET/CT for detecting multiple primary cancer of UGI tract were 90.9%, 85.7%, 89.4%, 80% and 93.7%, respectively.
The whole body (18)F-FDG PET/CT may play an important role in evaluating the multiple primary malignant tumors of UGI tract cancer.
评估（18）F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（（18）F-FDG PET/CT）检测上消化道（UGI）多原发癌的能力。
由于 X 线钡餐和 CT 扫描怀疑 UGI 原发癌，对 15 例患者（12 例无癌症史，3 例有上消化道癌史）进行了检查。随后进行了全身（18）F-FDG PET/CT 扫描进行初始分期或再分期。所有患者最终均通过内镜活检或手术证实。根据（18）F-FDG PET/CT 和内镜检查计算多原发恶性肿瘤的检出率。
（18）F-FDG PET/CT 扫描在 32 个可疑病变中呈阳性，30/32 为真阳性原发灶，2/32 为假阳性。在 15 个（18）F-FDG PET/CT 扫描阴性的可疑病变中，12/15 为真阴性，3/15 为假阴性。在 15 例患者中，12 例经病理证实为 29 个原发性同步肿瘤，包括 8 例食管癌伴胃癌，4 例下咽癌伴食管癌。另外 3 例患者有 4 个新的原发性异时性肿瘤，均为多发性原发性食管癌。PET/CT 成像检测到 11 例患者局部淋巴结转移。4 例患者同时检测到局部淋巴结转移和远处转移。以原发性病变为基础，（18）F-FDG PET/CT 检测 UGI 多原发癌的敏感性、特异性、准确性、阴性预测值和阳性预测值分别为 90.9%、85.7%、89.4%、80%和 93.7%。
全身（18）F-FDG PET/CT 可能对上消化道多原发恶性肿瘤的评估发挥重要作用。
