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目的探讨18F脱氧葡萄糖(FDG)-正电子发射体层显像(PET)在贲门胃底恶性肿瘤患者诊断治疗中的应用价值。方法1999年4月—2005年4月间对57例贲门胃底恶性肿瘤患者行全身FDG-PET检查,其中29例在PET检查前未经任何治疗,另外28例为综合治疗后复查。采用目测法结合半定量分析判读PET结果,与病理及随访结果对照。结果29例FDG-PET检查前未经任何治疗的患者中,25例T2~T4期原发肿瘤显影,4例T1期原发肿瘤未显影,FDG-PET定性诊断灵敏度86%(25/29);其中24例根治性手术治疗的患者切除胸、腹腔直径>1·0cm的淋巴结40处,FDG-PET正确定性诊断28处为恶性及12处为良性淋巴结;5例患者FDG-PET发现有远隔脏器转移未行根治性手术。28例综合治疗后复查FDG-PET的患者中,FDG-PET发现22例存在复发或转移。结论FDG-PET检查对于贲门胃底恶性肿瘤的定性、TNM分期及判断治疗效果有帮助,但必须结合其他检查才能发挥优势。
Objective To investigate the value of 18F deoxyglucose (FDG) - positron emission tomography (PET) in the diagnosis and treatment of patients with gastric cardia gastric malignancy. Methods From April 1999 to April 2005, 57 patients with cardiac cardia gastric cancer underwent whole-body FDG-PET examination. Of them, 29 patients were treated with PET before the procedure and the other 28 patients were reviewed after comprehensive treatment. Visual inspection combined with semi-quantitative analysis of interpretation of PET results, and pathology and follow-up results of the control. Results Of the 29 patients without any treatment before FDG-PET, 25 cases of T2 ~ T4 primary tumor developed, 4 cases of T1 primary tumor did not develop, FDG-PET qualitative diagnostic sensitivity of 86% (25/29) ; Of which 24 cases of radical surgical resection of the chest, abdominal diameter> 1.0cm in 40 lymph nodes, FDG-PET correctly diagnosed 28 malignant and 12 benign nodes; 5 patients FDG-PET found far Transseptal organ metastasis is not a radical surgery. Of 28 patients who underwent FDG-PET after FDG-PET, recurrence or metastasis was found in 22 patients. Conclusion The FDG-PET examination is helpful for the diagnosis of gastric cardia gastric malignancy, TNM staging and judgment of therapeutic effect, but it must be combined with other tests to obtain advantages.