Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
Department of Radiotherapy, Oncology Division, Mount Vernon Cancer Centre, Middlesex, UK.
Ann Oncol. 2012 Aug;23(8):2078-2082. doi: 10.1093/annonc/mdr599. Epub 2012 Jan 31.
Anal cancer is a rare tumour accounting for ∼2% of all colorectal cancers between 1997 and 2000 in the UK. Staging is still dominated by DRE (digital rectal examination), computed tomography (CT) and magnetic resonance imaging (MRI) imaging. The role of PET as a definitive modality is still emerging and there are relatively few adequate studies in the literature.
We looked at patients treated radically for anal cancer at Mount Vernon Cancer Centre (UK) between 2009 and 2010. Eighty-eight patients underwent treatment according to data-based coding records of which 46 had positron emission tomography (PET)/CT scans. Notes were unavailable for three patients. We compared staging following conventional modalities (DRE, MRI and CT) and PET/CT scans for these 43 patients.
In 18 patients, the PET/CT stage differed from MRI. PET/CT altered the stage in 42% of patients but changes in subsequent management were not implemented.
Our data show that PET/CT does alter staging in a significant number of cases although it did not lead to change in management under the current guidelines. Furthermore, there is agreement that PET/CT shows greater sensitivity for detection of lymph nodes and our study has demonstrated a distinct trend towards upstaging of anal cancer with PET/CT.
在英国，1997 年至 2000 年间，肛门癌占所有结直肠癌的比例约为 2%，是一种罕见的肿瘤。分期仍然以 DRE（直肠指检）、计算机断层扫描（CT）和磁共振成像（MRI）为主。PET 作为一种明确的检查方法的作用仍在出现，文献中相对较少有足够的研究。
我们观察了 2009 年至 2010 年期间在 Mount Vernon 癌症中心（英国）接受根治性治疗的肛门癌患者。88 例患者根据基于数据的编码记录接受治疗，其中 46 例接受了正电子发射断层扫描（PET）/CT 扫描。有 3 例患者的记录不可用。我们比较了这 43 例患者常规检查（DRE、MRI 和 CT）和 PET/CT 扫描后的分期结果。
在 18 例患者中，PET/CT 分期与 MRI 不同。PET/CT 在 42%的患者中改变了分期，但没有根据当前指南改变后续的管理。
我们的数据表明，尽管 PET/CT 没有改变当前指南下的治疗管理，但在相当多的病例中确实改变了分期。此外，人们一致认为 PET/CT 对淋巴结的检测具有更高的敏感性，我们的研究表明，PET/CT 对肛门癌有明显的分期上调趋势。
