Department of Biology and Function in the Head and Neck, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Eur Arch Otorhinolaryngol. 2012 May;269(5):1503-7. doi: 10.1007/s00405-011-1784-7. Epub 2011 Oct 9.
We assessed the sensitivity of positron emission tomography (PET) for detecting synchronous multiple primary cancers, particularly synchronous esophageal cancers in head and neck cancer patients. We retrospectively reviewed 230 head and neck cancer patients. All the patients routinely underwent the following examinations: urinalysis, occult blood, tumor marker detection [squamous cell carcinoma (SCC), cytokeratin fragment (CYFRA), and carcinoembryonic antigen (CEA)], esophagogastroduodenoscopy, colonoscopy (when CEA was high or occult blood was positive), abdominal ultrasonography, plain chest computed tomography (CT), and PET. Bronchoscopy was performed when CT revealed lung shadow of central region. Synchronous multiple primary cancers were detected in 42 (18.2%) patients. The diagnostic sensitivity of PET for synchronous primary cancers was as follows: esophagus, 7.6% (1/13); stomach, 25.0% (2/8); lung, 66.7% (4/6); head and neck, 75.0% (3/4); colon, 0% (0/1); kidney, 0% (0/1); and subcutaneous, 100% (1/1). The sensitivity of PET for detecting synchronous esophageal cancers is low because these are early-stage cancers (almost stage 0-I). Therefore, it is necessary to perform esophagogastroduodenoscopy for detecting synchronous esophageal cancers. PET is an important additional tool for detecting synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous head and neck cancer and lung cancer is high. But PET has the limitation of sensitivity for synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous esophageal cancer is very low.
我们评估了正电子发射断层扫描（PET）检测同步多原发癌的敏感性，尤其是头颈部癌症患者的同步食管癌。我们回顾性分析了 230 例头颈部癌症患者。所有患者均常规进行以下检查：尿分析、潜血、肿瘤标志物检测（鳞状细胞癌[SCC]、细胞角蛋白片段[CYFRA]和癌胚抗原[CEA]）、食管胃十二指肠镜、结肠镜（CEA 升高或潜血阳性时）、腹部超声、胸部 CT 平扫、PET。当 CT 显示中央区域肺阴影时，行支气管镜检查。42 例（18.2%）患者发现同步多原发癌。PET 诊断同步原发性癌症的敏感性如下：食管，7.6%（1/13）；胃，25.0%（2/8）；肺，66.7%（4/6）；头颈部，75.0%（3/4）；结肠，0%（0/1）；肾，0%（0/1）；皮下，100%（1/1）。PET 检测同步食管癌的敏感性较低，因为这些是早期癌症（几乎为 0 期-I 期）。因此，有必要进行食管胃十二指肠镜检查以检测同步食管癌。PET 是检测同步多原发癌的重要辅助工具，因为 PET 在同步头颈部癌和肺癌中的诊断敏感性较高。但是，PET 对同步多原发癌的敏感性有限，因为 PET 在同步食管癌中的诊断敏感性非常低。
