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目的探讨正电子发射型计算机体层扫描/计算机断层扫描仪(18F-FDGPET/CT)在探测胃肠道恶性肿瘤术后复发、转移中的应用价值。方法回顾性分析38例胃癌及结直肠癌术后患者全身PET/CT显像结果,临床随访时间为3～16个月,确诊依据为手术病理检查、多种影像学检查和临床随诊。结果38例患者中有24例肿瘤复发、转移。18F-FDGPET/CT诊断胃癌及结直肠癌复发、转移的灵敏度为95.8%,特异度为71.4%,阳性预测值为85.2%,阴性预测值为90.9%,正确率为86.8%。平扫CT诊断胃癌及结直肠癌复发、转移的灵敏度为45.8%,特异度为71.4%,阳性预测值为73.3%,阴性预测值为43.5%,正确率为55.3%。18F-FDGPET/CT诊断胃癌及结直肠癌复发、转移的灵敏度、阴性预测值及正确率均高于平扫CT,差异有统计学意义(P<0.05),18F-FDGPET/CT对胃癌及结直肠癌复发、转移的诊断与病理或临床随访证实结果显示两者密切相关(P<0.05)。结论18F-FDGPET/CT能灵敏、准确地检出胃肠道恶性肿瘤术后局部复发和转移病灶。
Objective To investigate the value of positron emission tomography / computed tomography (18F-FDG PET / CT) in the detection of recurrence and metastasis of gastrointestinal malignant tumors. Methods We retrospectively analyzed the results of whole body PET / CT in 38 patients with gastric cancer and colorectal cancer after operation. The clinical follow-up time ranged from 3 to 16 months. The diagnosis was based on surgical pathology, various imaging examinations and clinical follow-up. Results Of the 38 patients, 24 had tumor recurrence and metastasis. The sensitivity and specificity of 18F-FDG PET / CT for diagnosing recurrence and metastasis of gastric cancer and colorectal cancer were 95.8%, 71.4%, 85.2%, and 90.9%, respectively. The correct rate was 86.8%. The sensitivity and specificity of plain CT in diagnosing recurrence and metastasis of gastric cancer and colorectal cancer were 45.8%, 71.4%, 73.3%, 43.5%, and 55.3% respectively. The sensitivity, negative predictive value and accuracy of 18F-FDG PET / CT in the diagnosis of gastric cancer and colorectal cancer were significantly higher than those of plain CT (P <0.05), but 18F-FDG PET / CT showed no significant difference between gastric cancer and colorectal cancer The diagnosis of recurrence and metastasis is closely related to the pathological or clinical follow-up results (P <0.05). Conclusion 18F-FDG PET / CT can sensitively and accurately detect the local recurrence and metastasis of gastrointestinal malignant tumor.