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F-FDG PET/CT 可能是一种适合术前诊断和评估中国老年肝门部胆管癌患者的方法。

F-FDG PET/CT may be a suitable method for preoperative diagnosis and evaluation of Chinese older patients with hilar cholangiocarcinoma.

机构信息

Department of Pharmacy, Jining No.1 People's Hospital, Jining, China.

Department of Surgery, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

BMC Geriatr. 2018 Jul 6;18(1):150. doi: 10.1186/s12877-018-0846-8.

Abstract

BACKGROUND

As the most common cholangiocarcinoma, hilar cholangiocarcinoma (HCCA) is a challenge in hepatobiliary surgery and causes a very poor prognosis. This study was designed to explore whether F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) may be a suitable method for preoperative diagnosis and evaluation of Chinese older patients with hilar cholangiocarcinoma.

METHODS

This study enrolled 53 patients (≥ 65 years) with HCCA. F-FDG PET/CT scan was performed in all patients within one week before operation.

RESULTS

F-FDG PET/CT identified the tumors in all patients (100%). There were 48 patients (90.6%) with the same Bismuth-Corlette classifications determined by F-FDG PET/CT and operative pathology, whereas Bismuth-Corlette classifications of 5 patients (9.4%) were underestimated by F-FDG PET/CT compared with that determined by operative pathology. F-FDG PET/CT identified 19 patients (sensitivity: 67.9%) in 28 patients with lymph node metastases, and 22 patients (specificity: 88.0%) in 25 patients without lymph node metastases, with an accuracy of 77.4%. F-FDG PET/CT identified 8 patients (sensitivity: 47.1%) in 17 patients with liver, peritoneal or other distant metastases, and 35 patients (specificity: 97.2%) in 36 patients without liver, peritoneal or other distant metastases, with an accuracy of 81.1%. F-FDG PET/CT identified 17 patients (sensitivity: 73.9%) in 23 patients with unresectable tumors, and 24 patients (specificity: 80.0%) in 30 patients with resectable tumors, with an accuracy of 77.4%.

CONCLUSIONS

F-FDG PET/CT may be a suitable method for preoperative diagnosis and evaluation, and offer valuable information for effective operation in Chinese older patients with HCCA.

摘要

背景

作为最常见的胆管癌,肝门部胆管癌(HCCA)是肝胆外科的挑战,预后极差。本研究旨在探讨氟-18 氟代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)是否可作为中国老年 HCCA 患者术前诊断和评估的合适方法。

方法

本研究纳入了 53 例(≥65 岁)HCCA 患者。所有患者均在术前 1 周内行 F-FDG PET/CT 扫描。

结果

F-FDG PET/CT 可在所有患者中识别肿瘤(100%)。48 例(90.6%)患者的 F-FDG PET/CT 与手术病理的 Bismuth-Corlette 分类相同,而 5 例(9.4%)患者的 Bismuth-Corlette 分类被低估。F-FDG PET/CT 识别出 28 例淋巴结转移患者中的 19 例(敏感性:67.9%),25 例无淋巴结转移患者中的 22 例(特异性:88.0%),准确率为 77.4%。F-FDG PET/CT 识别出 17 例肝、腹膜或其他远处转移患者中的 8 例(敏感性:47.1%),36 例无肝、腹膜或其他远处转移患者中的 35 例(特异性:97.2%),准确率为 81.1%。F-FDG PET/CT 识别出 23 例不可切除肿瘤患者中的 17 例(敏感性:73.9%),30 例可切除肿瘤患者中的 24 例(特异性:80.0%),准确率为 77.4%。

结论

F-FDG PET/CT 可能是术前诊断和评估的合适方法,可为中国老年 HCCA 患者的有效手术提供有价值的信息。

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引用本文的文献

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Crit Rev Oncol Hematol. 2017 Aug;116:11-31. doi: 10.1016/j.critrevonc.2016.11.012. Epub 2016 Nov 25.
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Consensus conference on hilar cholangiocarcinoma.肝门部胆管癌共识会议
HPB (Oxford). 2015 Aug;17(8):666-8. doi: 10.1111/hpb.12451.
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Perioperative Management of Hilar Cholangiocarcinoma.肝门部胆管癌的围手术期管理
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