Friess H, Langhans J, Ebert M, Beger H G, Stollfuss J, Reske S N, Büchler M W
Department of Visceral and Transplantation Surgery, University of Berne, Inselspital, Switzerland.
Gut. 1995 May;36(5):771-7. doi: 10.1136/gut.36.5.771.
The detection of pancreatic cancer or the discrimination between pancreatic cancer and chronic pancreatitis remains an important diagnostic problem. The increased glucose metabolism in malignant tumours formed the basis for this investigation, which focused on the role of positron emission tomography (PET) with 2[18F]-fluoro-2-deoxy-D-glucose (FDG) in the detection of pancreatic cancer and its differentiation from chronic pancreatitis. Eighty patients admitted for elective pancreatic surgery received preoperatively 250-350 mBq FDG intravenously and emission scans were recorded 45 minutes later. Intense focal activity in the pancreatic region was taken at the time of scanning as showing the presence of pancreatic cancer. The presence of cancer was later confirmed by histological examination of the surgical specimens and histological findings were compared with the preoperative PET results. Forty one patients with pancreatic cancer (group I: n = 42) had a focally increased FDG uptake in the pancreatic region. Two patients with a periampullary carcinoma (group II: n = 6) failed to develop FDG accumulation. In 28 patients with chronic pancreatitis (group III: n = 32) no FDG accumulation occurred. Overall sensitivity and specificity of PET for malignancy (group I + II) were 94% (45 of 48) and 88% (28 of 32), respectively. The standard uptake value of the patients with pancreatic carcinoma was significantly higher than in patients with chronic pancreatitis (3.09 (2.18) v 0.87 (0.56); p < 0.001; median (interquartile range)). These findings show that FDG-PET represents a new and non-invasive diagnostic procedure for the diagnosis of pancreatic cancer and to differentiate pancreatic cancer from chronic pancreatitis. However, the diagnostic potential of this technique requires further evaluation.
胰腺癌的检测或胰腺癌与慢性胰腺炎的鉴别仍然是一个重要的诊断难题。恶性肿瘤中葡萄糖代谢增加是本研究的基础，该研究聚焦于使用2-[18F]-氟-2-脱氧-D-葡萄糖（FDG）的正电子发射断层扫描（PET）在胰腺癌检测及其与慢性胰腺炎鉴别中的作用。80例因择期胰腺手术入院的患者术前静脉注射250 - 350 mBq FDG，45分钟后进行发射扫描。扫描时胰腺区域的强烈局灶性活性被视为提示存在胰腺癌。随后通过手术标本的组织学检查证实癌症的存在，并将组织学结果与术前PET结果进行比较。41例胰腺癌患者（I组：n = 42）胰腺区域FDG摄取局灶性增加。2例壶腹周围癌患者（II组：n = 6）未出现FDG聚集。28例慢性胰腺炎患者（III组：n = 32）未出现FDG聚集。PET对恶性肿瘤（I组 + II组）的总体敏感性和特异性分别为94%（48例中的45例）和88%（32例中的28例）。胰腺癌患者的标准摄取值显著高于慢性胰腺炎患者（3.09（2.18）对0.87（0.56）；p < 0.001；中位数（四分位间距））。这些发现表明，FDG-PET是一种用于诊断胰腺癌以及区分胰腺癌与慢性胰腺炎的新的非侵入性诊断方法。然而，该技术的诊断潜力需要进一步评估。
