18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描对无症状非小细胞肺癌患者的术后随访很有用。
18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in postoperative follow-up of asymptomatic non-small-cell lung cancer patients.
作者信息
Toba Hiroaki, Sakiyama Shoji, Otsuka Hideki, Kawakami Yukikiyo, Takizawa Hiromitsu, Kenzaki Koichiro, Kondo Kazuya, Tangoku Akira
机构信息
Department of Thoracic and Endocrine Surgery and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
出版信息
Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):859-64. doi: 10.1093/icvts/ivs368. Epub 2012 Aug 21.
OBJECTIVES
Postoperative follow-up and surveillance after curative resection for non-small-cell lung cancer (NSCLC) patients are generally performed. However, there is no consensus on the best programme at this time. The aim of this study was to evaluate the diagnostic capability of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in postoperative NSCLC patients without clinical and radiological evidence of recurrence, as a follow-up and surveillance programme.
METHODS
Between January 2005 and April 2010, a total of 101 NSCLC patients underwent potentially curative operations and follow-up FDG-PET/CT was performed in patients without clinical and radiological evidence of recurrence at least once a year in principle. A total of 233 FDG-PET/CT studies were entered and retrospectively reviewed.
RESULTS
Eighteen (18%) asymptomatic patients had recurrent diseases and 22 recurrent sites were confirmed. Of 22 recurrent sites, recurrence was diagnosed by histological examination in 9 (41%) sites and by imaging examination in 13 (59%) sites. FDG-PET/CT correctly diagnosed recurrence in 17 of the 18 (94%) patients and 21 of the 22 (95%) recurrent sites. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 94.4, 97.6, 89.5, 98.8 and 97.0%, respectively. On the other hand, in 3 patients, other diseases were detected and treated appropriately. Post-recurrence therapies were performed in all patients with recurrence, but 4 (22%) patients died of the original diseases. The median post-recurrence survival was 25.2 months, and the 1- and 2-year post-recurrence survival rates were 83.3 and 69.6%, respectively.
CONCLUSIONS
FDG-PET/CT is a useful tool that has high capability to detect recurrences in asymptomatic NSCLC patients after a potentially curative operation. However, a large-scale multi-institutional randomized control trial may be needed to ascertain the benefit of surveillance with FDG-PET/CT.
目的
非小细胞肺癌（NSCLC）患者根治性切除术后通常会进行随访和监测。然而，目前对于最佳方案尚无共识。本研究的目的是评估（18）F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）作为一种随访和监测方案，在无临床和影像学复发证据的术后NSCLC患者中的诊断能力。
方法
2005年1月至2010年4月期间，共有101例NSCLC患者接受了根治性手术，原则上对无临床和影像学复发证据的患者每年至少进行一次随访FDG-PET/CT检查。共纳入233项FDG-PET/CT研究并进行回顾性分析。
结果
18例（18%）无症状患者出现疾病复发，共确认22个复发部位。在22个复发部位中，9个（41%）部位通过组织学检查确诊复发，13个（59%）部位通过影像学检查确诊复发。FDG-PET/CT在18例患者中的17例（94%）和22个复发部位中的21个（95%）正确诊断出复发。其敏感性、特异性、阳性预测值、阴性预测值和准确性分别为94.4%、97.6%、89.5%、98.8%和97.0%。另一方面，在3例患者中检测到其他疾病并进行了适当治疗。所有复发患者均接受了复发后治疗，但4例（22%）患者死于原发病。复发后的中位生存期为25.2个月，1年和2年复发后生存率分别为83.3%和69.6%。
结论
FDG-PET/CT是一种有用的工具，在根治性手术后的无症状NSCLC患者中检测复发的能力较高。然而，可能需要进行大规模的多机构随机对照试验来确定FDG-PET/CT监测的益处。
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