Kwee Thomas C, Basu Sandip, Alavi Abass
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Methods Mol Biol. 2011;727:317-33. doi: 10.1007/978-1-61779-062-1_17.
Carcinoma of unknown primary (CUP) is defined as histologically proven metastatic disease that, after a complete diagnostic work-up, yields no primary detectable tumor. CUP is one of the ten most frequent cancers, with overall poor outcome. Detection of the unknown primary tumor is of crucial importance in this scenario, since it might help to select and offer definitive treatment, which, in turn, may improve patient prognosis. Additional diagnostic work-up, usually consisting of a combination of several radiological and endoscopic investigations and serum tumor marker studies, can be time consuming, expensive, and pose a significant burden to the patient. The final diagnostic yield of these tests is often limited. Combined positron emission tomography/computed tomography (PET/CT), using the radiotracer (18)F-fluoro-2-deoxyglucose (FDG), may be of great value in the management of patients with CUP for the detection of primary tumors. This chapter gives a brief introduction to the syndrome of CUP, followed by an outline of the rationale, use, and utility of FDG-PET/CT in CUP, and concludes with a discussion on the challenges and future directions in the diagnostic management of patients with CUP.
原发灶不明的癌（CUP）被定义为经组织学证实的转移性疾病，在经过全面的诊断检查后，未发现可检测到的原发肿瘤。CUP是最常见的十种癌症之一，总体预后较差。在这种情况下，检测出不明原发肿瘤至关重要，因为这可能有助于选择并提供确定性治疗，进而改善患者预后。额外的诊断检查通常包括多种放射学和内镜检查以及血清肿瘤标志物研究的组合，可能耗时、昂贵，且给患者带来巨大负担。这些检查的最终诊断阳性率往往有限。使用放射性示踪剂（18）F - 氟 - 2 - 脱氧葡萄糖（FDG）的联合正电子发射断层扫描/计算机断层扫描（PET/CT）在CUP患者的管理中对于检测原发肿瘤可能具有重要价值。本章简要介绍CUP综合征，接着概述FDG - PET/CT在CUP中的原理、应用和效用，并以对CUP患者诊断管理中的挑战和未来方向的讨论作为结尾。
