Yang Zhong-Yi, Hu Si-Long, Shi Wei, Zhu Bei-Ling, Xu Jun-Yan, Zhang Ying-Jian
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.
Nucl Med Commun. 2011 Nov;32(11):1018-25. doi: 10.1097/MNM.0b013e32834bbd22.
To evaluate the clinical value of F-fluorodeoxyglucose positron emission tomography and computed tomography (¹⁸F-FDG PET/CT) in postoperative patients with gastrointestinal mucinous adenocarcinoma.
From July 2007 to March 2009, 30 patients who had previous surgical resection of histopathologically diagnosed gastrointestinal mucinous adenocarcinoma underwent ¹⁸F-FDG PET/CT scans in our center. The standard of reference for tumor recurrence, regional lymph node (LN) metastasis, peritoneal and distant metastasis consisted of histopathologic confirmation or clinical follow-up information for at least 6 months after PET/CT examinations.
With final diagnosis, tumor recurrences were confirmed in eight of the 30 patients (26.7%). If a maximum standardized uptake value (SUVmax) of 2.5 or more was used as a cut-off point, the sensitivity, specificity, and accuracy of PET/CT were 87.5, 77.3, and 80.0%, respectively. However, if an SUVmax of 4.0 or more was the criterion, the sensitivity, specificity, and accuracy were 25.0, 86.4, and 70.0%, respectively. A cut-off point of 2.5 showed a higher sensitivity (P=0.041), and there was no statistical difference in the specificity and the accuracy of these two criteria. For the diagnosis of metastasis in regional LNs and peritoneum, the detection rate was 95.2 and 86.4%, respectively. In addition, we followed up 20 patients with 26 suspicious distant lesions. The sensitivity, specificity, and accuracy were 58.3, 92.9, and 76.9%, respectively.
¹⁸F-FDG PET/CT may be effective to discriminate tumor recurrence, and to detect regional LNs, peritoneal and distant metastasis in postoperative patients with gastrointestinal mucinous adenocarcinoma.
评估氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描（¹⁸F-FDG PET/CT）在胃肠道黏液腺癌术后患者中的临床价值。
2007年7月至2009年3月，30例经组织病理学诊断为胃肠道黏液腺癌且先前接受过手术切除的患者在本中心接受了¹⁸F-FDG PET/CT扫描。肿瘤复发、区域淋巴结（LN）转移、腹膜及远处转移的参考标准包括PET/CT检查后至少6个月的组织病理学证实或临床随访信息。
最终诊断显示，30例患者中有8例（26.7%）确诊肿瘤复发。若将最大标准化摄取值（SUVmax）≥2.5作为截断点，PET/CT的敏感性、特异性和准确性分别为87.5%、77.3%和80.0%。然而，若以SUVmax≥4.0为标准，敏感性、特异性和准确性分别为25.0%、86.4%和70.0%。截断点为2.5时显示出更高的敏感性（P = 0.041），这两个标准在特异性和准确性方面无统计学差异。对于区域LN和腹膜转移的诊断，检测率分别为95.2%和86.4%。此外，我们对20例有26处可疑远处病变的患者进行了随访。敏感性、特异性和准确性分别为58.3%、92.9%和76.9%。
¹⁸F-FDG PET/CT可能有助于鉴别胃肠道黏液腺癌术后患者的肿瘤复发，并检测区域LN、腹膜及远处转移。
