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[目的]通过测量直肠癌原发病灶~(18)F-FDG PET/CT的代谢参数,探讨其在诊断直肠癌转移上的临床应用价值。[方法]回顾性分析经病理证实为直肠癌并行全身~(18)FDG PET/CT显像的患者79例,术前未行其他治疗。记录患者年龄、性别、CEA、病理类型、病变部位、T分期、原发灶的密度、最大径、最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)和总糖酵解量(TLG);根据病理结果和其他影像学检查验证是否存在转移灶。采用单因素方差分析法分析有转移组和无转移组原发灶各参数与转移的关系;多因素二元Logistic回归分析观察代谢参数与转移的关系,排除混杂因素并筛选诊断转移的独立影响因素;ROC曲线分别分析有统计学意义的因素诊断直肠癌转移的效能。[结果]单因素分析结果显示CEA、原发灶CT值、MTV和TLG与转移有关(P均<0.05)。多因素Logistic回归分析结果显示仅CEA和原发灶TLG与转移有关(P=0.035、0.018)。分别绘制CEA、TLG和CEA联合TLG诊断直肠癌患者转移的ROC曲线,三者预测直肠癌转移的ROC曲线下面积分别为0.684、0.855和0.842;诊断转移的灵敏度分别为72.2%、94.4%和75.0%,特异性分别为62.8%、76.7%和81.1%,准确性分别为68.4%、78.5%和78.5%。[结论]直肠癌患者血清CEA、原发灶CT值、MTV和TLG与转移存在相关性。血清CEA和原发灶TLG是诊断转移的独立因素。CEA联合TLG诊断转移效能并不优于TLG独立诊断转移。TLG作为诊断直肠癌转移的因素,有较好的准确性,可为临床制定合理治疗方案提供帮助。
[Objective] To investigate the clinical value of ~ (18) F-FDG PET / CT in detecting the metastatic potential of rectal cancer. [Methods] A total of 79 patients with pathological confirmed concurrent ~ (18) FDG PET / CT imaging of rectal cancer were retrospectively analyzed. No other treatment was performed before operation. The age, gender, CEA, pathological type, lesion location, T stage, density of primary tumor, maximum diameter, maximum normalized uptake value (SUVmax), tumor metabolic volume (MTV) and total glycolysis (TLG) According to pathological findings and other imaging studies to verify the existence of metastases. One-way ANOVA was used to analyze the relationship between the parameters of primary metastasis and non-metastasis metastasis. Multivariate Logistic regression analysis was used to observe the relationship between metabolic parameters and metastasis, to exclude confounding factors and to screen independent influencing factors ; ROC curve analysis of statistically significant factors in the diagnosis of metastatic colorectal cancer efficacy. [Results] The results of univariate analysis showed that CEA, CT value of primary tumor, MTV and TLG were related to metastasis (all P <0.05). Multivariate Logistic regression analysis showed that only CEA and primary tumor TLG were associated with metastasis (P = 0.035,0.018). The ROC curves of CEA, TLG and CEA combined with TLG in the diagnosis of rectal cancer were respectively plotted. The areas under the ROC curve of the three were 0.684,0.855 and 0.842, respectively. The diagnostic sensitivity of metastasis was 72.2%, 94.4% and 75.0 %, The specificity was 62.8%, 76.7% and 81.1%, the accuracy was 68.4%, 78.5% and 78.5% respectively. [Conclusion] There is a correlation between serum CEA, CT value of primary tumor, MTV, TLG and metastasis in patients with rectal cancer. Serum CEA and primary tumor TLG are independent factors in the diagnosis of metastasis. CEA combined TLG diagnostic transfer efficiency is not better than TLG independent diagnosis of metastasis. TLG as a diagnosis of metastasis of colorectal cancer, with good accuracy, can provide a reasonable clinical treatment plan to help.