Siekiera Jerzy, Małkowski Bogdan, Jóźwicki Wojciech, Jasiński Miłosz, Wronczewski Andrzej, Pietrzak Tomasz, Chmielowska Ewa, Petrus Andrzej, Kamecki Krzysztof, Mikołajczak Witold, Kraśnicki Krzysztof, Chłosta Piotr, Drewa Tomasz
Department of Urology, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
Urol Int. 2012;88(4):405-9. doi: 10.1159/000337056. Epub 2012 Apr 12.
The management of residuals after completion of chemotherapy in advanced seminoma is controversial. It has been proposed that fluorodeoxyglucose-positron emission tomography (FDG-PET) can be used as a follow-up. In this study we investigated FDG-PET as a follow-up tool in advanced seminoma patients treated previously with chemotherapy or radiotherapy. Thirty-seven patients assigned to an advanced seminoma group based on CT and/or FDG-PET/CT and then treated with chemotherapy were included in the study. All these patients underwent FDG-PET/CT examination as a part of the follow-up scheme. Patients underwent retroperitoneal lymph node dissection (RPLND), radiotherapy, or were followed clinically by CT and/or PET/CT every 6 months. In 8 cases FDG-PET was positive: 5 of them underwent RPLND and 3 radiotherapy. Two patients with negative FDG-PET but positive CT also underwent RPLND. The remaining patients with negative FDG-PET results were followed up. FDG-PET/CT was false positive in one case >3 cm and one <3 cm, in 6 cases >3 cm it was true negative. While FDG-PET can find a viable tumor, there also is an important question of false positive results. It was clinically proven that a negative FDG-PET was correlated with stable disease, but we were unable to examine specimens in these cases.
晚期精原细胞瘤化疗结束后残留病灶的处理存在争议。有人提出氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）可用于随访。在本研究中，我们调查了FDG-PET作为先前接受过化疗或放疗的晚期精原细胞瘤患者的随访工具。37例根据CT和/或FDG-PET/CT被归入晚期精原细胞瘤组并随后接受化疗的患者纳入了本研究。所有这些患者均接受了FDG-PET/CT检查作为随访方案的一部分。患者接受了腹膜后淋巴结清扫术（RPLND）、放疗，或每6个月通过CT和/或PET/CT进行临床随访。8例FDG-PET呈阳性：其中5例接受了RPLND，3例接受了放疗。2例FDG-PET阴性但CT阳性的患者也接受了RPLND。其余FDG-PET结果为阴性的患者进行了随访。FDG-PET/CT在1例>3 cm和1例<3 cm的病例中出现假阳性，在6例>3 cm的病例中为真阴性。虽然FDG-PET可以发现存活肿瘤，但假阳性结果也是一个重要问题。临床证明FDG-PET阴性与病情稳定相关，但我们无法在这些病例中检查标本。
