Xu Haoping, Guo Rui, Xu Weihui, Pan Yanying, Ma Tao
Department of Radiochemotherapy, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
Department of Nuclear Medicine, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
South Asian J Cancer. 2017 Apr-Jun;6(2):59-63. doi: 10.4103/2278-330X.208853.
Retrospectively analyze the sensitivity of F-fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG PET-CT) in the diagnosis of gastric malignancy compared with gastric endoscopy in persons with nonspecific symptoms and evaluate the necessity of F-FDG PET-CT scan before surgery.
A total of 53 patients with gastric malignancy proven by surgery and pathology were enrolled in the study. All the patients underwent gastric endoscopy and PET-CT scan before surgery. And the PET-CT images were interpreted by the observers who were blinded to the results of the gastric endoscopy. The sensitivity of gastric endoscopy, F-FDG PET-CT, and serum tumor markers in the diagnosis of gastric malignancy were calculated ultimately.
Of 53 gastric malignancy patients, five cases were proven to be false-negative detected by gastric endoscopy, and the sensitivity of which was 90.57%. The sensitivity of PET scan alone was 86.79%, which was observed no significant difference to that of gastric endoscopy diagnosis, = 0.54. While all of the patients had been detected positive on PET-CT images, the sensitivity of which was significantly higher than that of the gastric endoscopy diagnosis or that of the serum tumor markers, < 0.001. And the FDG uptake was positively correlated with the depth of the cancer invasion into the gastric wall ( < 0.0001) and the degree of lymph nodes infiltration ( = 0.02). It also various from different differentiation degree significantly, = 0.04.
F-fluorodeoxyglucose PET-CT could detect gastric carcinoma in persons with nonspecific symptoms which showed negative in gastric endoscopy. And it is necessary to be aware of the possibility of gastric malignancy when the result of PET-CT scan is positive.
回顾性分析氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG PET-CT）在诊断非特异性症状患者胃恶性肿瘤方面相对于胃镜检查的敏感性，并评估术前进行F-FDG PET-CT扫描的必要性。
本研究共纳入53例经手术及病理证实为胃恶性肿瘤的患者。所有患者术前均接受胃镜检查及PET-CT扫描。PET-CT图像由对胃镜检查结果不知情的观察者解读。最终计算胃镜检查、F-FDG PET-CT及血清肿瘤标志物诊断胃恶性肿瘤的敏感性。
53例胃恶性肿瘤患者中，胃镜检查发现5例假阴性病例，其敏感性为90.57%。单纯PET扫描的敏感性为86.79%，与胃镜诊断相比差异无统计学意义，P = 0.54。而所有患者在PET-CT图像上均显示为阳性，其敏感性显著高于胃镜诊断及血清肿瘤标志物，P < 0.001。FDG摄取与癌组织侵犯胃壁深度（P < 0.0001）及淋巴结浸润程度（P = 0.02）呈正相关。在不同分化程度中也存在显著差异，P = 0.04。
F-氟脱氧葡萄糖PET-CT可检测出胃镜检查结果为阴性的非特异性症状患者中的胃癌。当PET-CT扫描结果为阳性时，有必要警惕胃恶性肿瘤的可能性。
