Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, Gunma, Japan.
Department of Innovative Cancer Immunotherapy, Gunma University, Gunma, Japan.
J Surg Oncol. 2021 Sep;124(3):317-323. doi: 10.1002/jso.26513. Epub 2021 May 12.
Tumor invasion is the most significant prognostic factor in ampullary cancer and is thus a crucial factor in decision making for treatment. Endoscopic ultrasound can be performed to evaluate tumor invasion, but its diagnostic accuracy varies depending on the endoscopist. This study aimed to assess the usefulness of fluorodeoxyglucose positron emission tomography (FDG-PET) for preoperatively predicting tumor invasion in ampullary cancer.
We retrospectively evaluated 44 patients with ampullary cancer (adenoma, n = 6; adenocarcinoma, n = 38) who underwent surgical resection. The SUVmax of the ampullary tumor site was assessed using FDG-PET, and the correlation among tumor invasion, lymph node metastasis, and other clinicopathological factors was evaluated.
The SUVmax of the ampullary tumor site gradually increased depending on the extent of tumor invasion (p = 0.0075). Moreover, the SUVmax was significantly different between ≤T1a and ≥T1b, which is an indication for endoscopic papillectomy or surgical resection (p = 0.0015). The SUVmax of the ampullary section was significantly correlated with lymph node metastasis (p = 0.035).
The SUVmax of the ampullary tumor site is correlated with tumor invasion and lymph node metastasis in ampullary cancer. Thus, FDG-PET can be a useful modality for preoperative staging and treatment strategy.
肿瘤侵犯是壶腹癌最重要的预后因素，因此是治疗决策的关键因素。可以进行内镜超声检查来评估肿瘤侵犯，但诊断准确性取决于内镜医生。本研究旨在评估氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在术前预测壶腹癌肿瘤侵犯中的作用。
我们回顾性评估了 44 例接受手术切除的壶腹癌患者（腺瘤，n=6；腺癌，n=38）。使用 FDG-PET 评估壶腹部肿瘤部位的 SUVmax，并评估肿瘤侵犯、淋巴结转移和其他临床病理因素之间的相关性。
肿瘤侵犯程度越高，壶腹部肿瘤部位的 SUVmax 逐渐增加（p=0.0075）。此外，SUVmax 在≤T1a 和≥T1b 之间有显著差异，这是内镜乳头切除术或手术切除的指征（p=0.0015）。壶腹部的 SUVmax 与淋巴结转移显著相关（p=0.035）。
壶腹部肿瘤部位的 SUVmax 与壶腹癌的肿瘤侵犯和淋巴结转移相关。因此，FDG-PET 可作为术前分期和治疗策略的有用手段。
