结直肠癌与 18FDG-PET/CT：在局部区域分期中增加 N 参数的 T 有何意义？
Colorectal cancer and 18FDG-PET/CT: what about adding the T to the N parameter in loco-regional staging?
机构信息
Istituto di Biostrutture e Bioimmagini Consiglio Nazionale delle Ricerche, Naples 80131, Italy.
出版信息
World J Gastroenterol. 2011 Mar 21;17(11):1427-33. doi: 10.3748/wjg.v17.i11.1427.
AIM
To evaluate whether FDG-positron emission tomography (PET)/computed tomography (CT) may be an accurate technique in the assessment of the T stage in patients with colorectal cancer.
METHODS
Thirty four consecutive patients (20 men and 14 women; mean age: 63 years) with a histologically proven diagnosis of colorectal adenocarcinoma and scheduled for surgery in our hospital were enrolled in this study. All patients underwent FDG-PET/CT preoperatively. The primary tumor site and extent were evaluated on PET/CT images. Colorectal wall invasion was analysed according to a modified T classification that considers only three stages (≤ T2, T3, T4). Assessment of accuracy was carried out using 95% confidence intervals for T.
RESULTS
Thirty five/37 (94.6%) adenocarcinomas were identified and correctly located on PET/CT images. PET/CT correctly staged the T of 33/35 lesions identified showing an accuracy of 94.3% (95% CI: 87%-100%). All T1, T3 and T4 lesions were correctly staged, while two T2 neoplasms were overstated as T3.
CONCLUSION
Our data suggest that FDG-PET/CT may be an accurate modality for identifying primary tumor and defining its local extent in patients with colorectal cancer.
目的
评估氟代脱氧葡萄糖正电子发射断层扫描（PET）/计算机断层扫描（CT）是否可作为评估结直肠癌患者 T 分期的准确技术。
方法
本研究纳入了 34 例连续的经组织学证实患有结直肠腺癌且计划在我院接受手术的患者（20 名男性，14 名女性；平均年龄：63 岁）。所有患者均在术前接受了 FDG-PET/CT 检查。PET/CT 图像评估原发肿瘤部位和范围。根据仅考虑三个阶段（≤T2、T3、T4）的改良 T 分类分析结直肠壁侵犯情况。使用 T 的 95%置信区间进行准确性评估。
结果
在 PET/CT 图像上共识别出 35/37（94.6%）例腺癌并正确定位。PET/CT 正确分期了 33/35 例确定的病变 T 分期，准确率为 94.3%（95%CI：87%-100%）。所有 T1、T3 和 T4 病变均被正确分期，而 2 例 T2 肿瘤被高估为 T3。
结论
我们的数据表明，FDG-PET/CT 可能是一种识别结直肠癌患者原发肿瘤并定义其局部范围的准确方法。
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