Lee Joo Young, Yoon Soon Man, Kim Jeong Tae, Kim Ki Bae, Kim Mi Jin, Park Jae Geun, Lee Taek-Gu, Lee Sang-Jeon, Koong Sung Soo, Han Joung-Ho, Chae Hee Bok, Park Seon Mee, Youn Sei Jin
Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
Intest Res. 2017 Apr;15(2):208-214. doi: 10.5217/ir.2017.15.2.208. Epub 2017 Apr 27.
BACKGROUND/AIMS: F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC.
We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value.
For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (=0.029, =0.000, and =0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (=1.000, =0.004, and =0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (=0.009, =0.001, respectively).
Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.
背景/目的：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）已用于结直肠癌（CRC）的术前分期。然而，FDG-PET/CT检测淋巴结或远处转移的诊断准确性及其预后作用尚未完全明确。因此，我们评估了FDG-PET/CT与传统CT相比在CRC中的诊断和预后价值。
我们调查了220例行术前FDG-PET/CT和CT检查，随后接受CRC根治性手术的患者。评估了FDG-PET/CT和CT检测淋巴结转移和远处转移的敏感性、特异性、准确性、阳性预测值和阴性预测值。此外，我们根据包括癌症复发和癌症相关死亡在内的结果评估了FDG-PET/CT和CT的检查结果，以评估其预后价值。
对于检测淋巴结转移，FDG-PET/CT的敏感性为44%，特异性为84%，准确性为67%，而CT的敏感性、特异性和准确性分别为59%、65%和62%（P=0.029、P=0.000和P=0.022）。对于远处转移，FDG-PET/CT的敏感性为79%，特异性为94%，准确性为93%，而CT的敏感性、特异性和准确性分别为79%、87%和86%（P=1.000、P=0.004和P=0.037）。此外，FDG-PET/CT上淋巴结转移和远处转移的阳性结果与癌症复发或癌症相关死亡显著相关（P分别为0.009和0.001）。
术前FDG-PET/CT在检测CRC淋巴结转移和远处转移方面比CT具有更高的特异性和准确性。此外，FDG-PET/CT可能是CRC的一种有价值的预后工具。
